| NPI | 1972685097 |
|---|---|
| Doing Business As | GULF COAST SAV-REX #631 |
| Entity Type | Organization |
| Authorized Contact | MODENA S CANNON Pharmacy Operations Manager 228-769-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 01128/01.2) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-10-01 |