| NPI | 1952933038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEVEEN NOFAL PIC 865-765-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-07-10 |