NPI | 1205363777 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN EUGENE BURR Secretary 712-310-4701 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
3336C0003X Pharmacy, Community/Retail Pharmacy | |
Enumeration Date | 2017-05-16 |
Last Update Date | 2024-02-09 |