| NPI | 1043381825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK R GROVE President 812-265-4621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 60006043A) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY IN1246) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 60006043A) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IN 60006043A) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-09-25 |