| NPI | 1164403069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM BORDER Authorized Signer 800-225-5967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: TX 19617) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 19617) | |
| 333600000X Pharmacy (Licence: TX 19617) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2010-04-23 |