| NPI | 1174305528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JAMES POQUETTE Director Of Specialty Pharmacy 508-277-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-19 |