| NPI | 1093204604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MANION Owner 860-343-5220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2023-01-11 |