| NPI | 1124032198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANT MOSHANG Controller 410-910-1578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL PH19929) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1312764) |
| 333600000X Pharmacy (Licence: AL 112679) | |
| 333600000X Pharmacy (Licence: CO 5590) | |
| 333600000X Pharmacy (Licence: CT 721) | |
| 333600000X Pharmacy (Licence: DE A9-0000676) | |
| 333600000X Pharmacy (Licence: ID 1964MS) | |
| 333600000X Pharmacy (Licence: IL 054.015544) | |
| 333600000X Pharmacy (Licence: IN 64000732A) | |
| 333600000X Pharmacy (Licence: IA 3604) | |
| 333600000X Pharmacy (Licence: KS 22-02344) | |
| 333600000X Pharmacy (Licence: KY FL1144) | |
| 333600000X Pharmacy (Licence: ME M040000688) | |
| 333600000X Pharmacy (Licence: MD P04376) | |
| 333600000X Pharmacy (Licence: MI 5301008460) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-03-07 |