| NPI | 1174976427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHATU ERLBACHER PIC/Owner 402-200-9834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2022-12-19 |