| NPI | 1942847686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME P. BALL Dr./Owner 606-310-3910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-02 |