| NPI | 1265693519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBERT Sr. Director, Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: VA 0201004233) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2016-12-05 |