| NPI | 1255180329 |
|---|---|
| Other Name | LIBERTY STREET |
| Entity Type | Organization |
| Authorized Contact | RENATO J SUNTAY CFO 814-333-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |