| NPI | 1093547705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARITZA MORA Director Of Legal And Compliance 430-213-1563 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 251F00000X Home Infusion |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-12-02 |