| NPI | 1063879096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKOLAS SHOEMAKER CFO / Owner 800-757-9192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: WV SP0552505) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2023-06-28 |