| NPI | 1043700933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZIE HAHN Ncpdp COO Rdinator 888-590-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MS R867568) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |