| NPI | 1053081364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERIK WANDELL Supervising Pharmacist 607-734-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-09-17 |