NPI | 1104217223 |
---|---|
Entity Type | Organization |
Authorized Contact | ANASTASIA JB GREER Credentialing Coordinator 802-448-9719 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2015-02-11 |
Last Update Date | 2015-02-11 |