| NPI | 1093337024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE RUSSELL Pharmacy Director 419-221-3072 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |