| NPI | 1013902188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE K HOFAMMANN Supervising Pharmacist 256-355-8015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 011106) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: AL 109900) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2020-08-22 |