| NPI | 1982761367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN WATSON VP Of Pharmacy Division 662-634-4347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 07162/5.2) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2018-07-19 |