NPI | 1962999789 |
---|---|
Entity Type | Organization |
Authorized Contact | VELEKA GRADY Pharmacist 601-353-6142 |
Organization Subpart ? | Yes |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy |
Enumeration Date | 2018-04-17 |
Last Update Date | 2022-11-10 |