| NPI | 1144224049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN LAWRENCE FETTMAN Owner Pharmacist 330-454-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OH 02-0108200) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2007-07-24 |