| NPI | 1134218787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY ALLEN VP Mgr Director 765-529-1338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IN 60004040A) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |