| NPI | 1154592525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K GRUBBS Executive Director 330-455-5950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 573) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-03-13 |