| NPI | 1063757631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WOLAK President/CEO 203-518-1146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: CT 0002254) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2018-10-29 |