| NPI | 1154574010 |
|---|---|
| Doing Business As | INDEPENDENT RX LONG TERM CARE |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY CLARK President 937-610-3051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: OH 021907400) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2021-11-03 |