| NPI | 1245390475 |
|---|---|
| Doing Business As | DAVITA MEDICAL GROUP, PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH18512) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-08-20 |