| NPI | 1154893600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MCCABE Secretary 820-245-4968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2026-07-13 |