| NPI | 1124579024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH HARTMAN COO 800-665-2850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: MD P07613) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: VA 0201004794) | |
| 333600000X Pharmacy (Licence: WV MO0561107) | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2022-04-25 |