| NPI | 1952537029 |
|---|---|
| Doing Business As | SOUTHERN LTC |
| Entity Type | Organization |
| Authorized Contact | JAMES GABLE PIC 662-328-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MS 08072/2.0) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2017-02-14 |