| NPI | 1235870635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA KATHLEEN LAPINSKI Operations Manager 833-257-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-07 |