| NPI | 1881997336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTICE E.K. HAGAN Pharmacy Manager 267-773-8349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP482063) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2017-07-06 |