| NPI | 1265123038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK KELSO TAYLOR CEO 855-927-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |