| NPI | 1982796546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD HUGHES MCCULLOUGH Partner Pharmacist 662-838-2521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 01322011) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-10-17 |