| NPI | 1912488198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LEANN CHAMBERS Pharmacist In Charge 662-820-4305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MS 17118) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy (Licence: MS 17118) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2023-03-07 |