| NPI | 1912381609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L CROUSE Owner 870-265-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 14410/1.1) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-11-09 |