| NPI | 1972893006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYMON TIGRETT Owner 601-573-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: MS 08886/02.6) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-05-16 |