| NPI | 1982789277 |
|---|---|
| Former Legal Business Name | WILLIAM MICHAEL RICHARDSON |
| Entity Type | Organization |
| Authorized Contact | MORGAN BAKER Pharmacist/Owner 731-608-6302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 1458) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 00001458) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2018-03-16 |