| NPI | 1134277130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK WOLKEN Owner,President,AO 330-332-9919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OH 020511950) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2015-09-14 |