| NPI | 1982253738 |
|---|---|
| Other Name | SPACE CITY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN MOORE Managing Member 832-569-5062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2021-07-19 |