| NPI | 1174505036 |
|---|---|
| Doing Business As | COMPUTERX PHARMACY IV |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILLIAM LICAMELE Cheif Executive Officer 203-375-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 1524) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-08-22 |