| NPI | 1114020872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBERT Director 401-765-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: GA 005160) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-09-08 |