| NPI | 1043646805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MYERS Owner 877-327-8881 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA PHY.006202) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: LA PHY.006202) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: LA PHY.006202) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2015-04-23 |