NPI | 1215134309 |
---|---|
Entity Type | Organization |
Authorized Contact | MIKE KALBAUGH Credentialing Specialist 336-878-8824 |
Organization Subpart ? | No |
Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: TN 000002963) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy, Compounding Pharmacy | |
Enumeration Date | 2007-07-02 |
Last Update Date | 2023-03-07 |