| NPI | 1184051948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA TRAST Pharmacist 920-499-5889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 051-039854) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |