| NPI | 1104437896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JAMES POQUETTE Director Of Specialty Pharmacy 508-234-4366 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2021-01-28 |