| NPI | 1013934413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CANONIC Senior Director, Enrollment 479-371-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: ND 965) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy (Licence: MT PHA-MOP-LIC-12447) |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: MN 262265) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: KY FL873) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: IL 054.015021) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: IN 64000468A) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: LA PHY.005063-OS) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: TX 22601) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: TN 3872) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: MI 5301007714) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: MO 2003010214) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: OK 99-6096) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: FL PH18943) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: OH 021368750-03) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: AR OS01543) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-06-12 |