| NPI | 1013454396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER MCDANIEL Compliance Officer 866-777-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: UT 10283835-1703) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-04-21 |