| NPI | 1962874602 |
|---|---|
| Doing Business As | SUPER 1 FOODS PHARMACY #642 |
| Entity Type | Organization |
| Authorized Contact | JIM COUSINEAU Senior VP Pharmacy Operations 903-877-6829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 30243) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2016-09-21 |