| NPI | 1164209128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR JOSEPH PERINI Assistant Secretary 314-684-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |