| NPI | 1891381265 |
|---|---|
| Doing Business As | CIP NORTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CODY CLARK Managing Officer 806-451-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2020-12-18 |