| NPI | 1003404609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY DAVIS Director 307-333-1054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 251E00000X Home Health |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-05-18 |