| NPI | 1962760827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLIN GINGRICH Compliance COO Rdinator 281-232-3940 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 28881) |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2017-04-10 |