NPI | 1144611500 |
---|---|
Entity Type | Organization |
Authorized Contact | ANASTASIA JB GREER Credentialing COO Rdinator 802-448-9719 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2015-02-06 |
Last Update Date | 2015-02-06 |