| NPI | 1134533631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN KRIVONAK Pharmacist 330-559-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03331264) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |