NPI | 1033123989 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT B. AVERY President 307-787-6756 |
Organization Subpart ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: WY 1731) |
Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WY 5202407) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2020-08-22 |