| NPI | 1265544274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SHELTON President 937-253-4108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: OH 010724550) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: OH 010724550) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 010724550) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-12-12 |