| NPI | 1033135983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA J COLE Vice President 855-733-3126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CA PHY54649) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY54649) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-05-08 |