| NPI | 1164437711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIEL HOPPENRATH PIC 270-234-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2024-02-07 |