| NPI | 1205847340 |
|---|---|
| Doing Business As | DEWITT PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | DENNIS BOUSSELOT President 563-659-5042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IA 1212) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-08-28 |