| NPI | 1891400990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON PAUL GIBSON Manager 432-296-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-06-28 |