| NPI | 1083176721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY M KRUTH Vice President Of Finance 888-331-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |