| NPI | 1265077069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN FORREST Outpatient Pharmacy/ 340 B Director 607-798-5944 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-15 |