| NPI | 1881738938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY TODD GEAN Owner 731-925-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 5550) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2011-09-27 |