| NPI | 1184353807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J VINEBURG Owner 262-261-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2023-05-04 |