| NPI | 1164050761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LYNCH Director Of Regulatory Services 317-969-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |