| NPI | 1871688457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WILLIAM DUCKWORTH Pharmacist In Charge 662-728-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00694) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |