| NPI | 1063465904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L GERHART Owner Pharmacist 765-447-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IN 60002772A) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IN 60002772A) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-08-15 |