| NPI | 1255443180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBERT Director 401-765-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MI 5301-005061) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-10-05 |