| NPI | 1194906172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS PAGE Authorized Official 970-250-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: NJ 28RS00675800) |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: NJ 28rs00675800) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NJ 28RS00675800) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2025-04-25 |