| NPI | 1205615606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UMAR FAROOQ Owner 272-800-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |