| NPI | 1891123675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS BUSS Pharmacist/Owner 731-286-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TN 5242) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2025-03-17 |