| NPI | 1215944236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE HENK Manager 765-449-1902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IN 60005100A) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-03-26 |