| NPI | 1962502203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ATKINSON Sr. Dir. Pharmacy Payor Contracting 806-242-7782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: TX 16559) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-12-21 |