| NPI | 1104129667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TUDOR MOWBRAY Owner 937-716-9933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2019-02-04 |