| NPI | 1871035659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GLENN PIC/Managing Member 662-580-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 12429) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |