NPI | 1265695852 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDY L. CAMPA Providership Supervisor 800-225-5967 |
Organization Subpart ? | No |
Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
Enumeration Date | 2008-07-03 |
Last Update Date | 2008-07-03 |