| NPI | 1912452921 |
|---|---|
| Doing Business As | SPORTS MEDICINE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RANDY CALVERT Registered Pharmacist 601-672-1534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 14908) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2017-01-13 |