| NPI | 1265904924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN EUGENE BURR Secretary 712-310-4701 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 251F00000X Home Infusion |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2024-04-12 |