| NPI | 1003802455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENIO EDWARDO VALDEZ Qualifying Pharmacist 574-970-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IN 60005127A) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-08-22 |