| NPI | 1275180507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GRAVES VP 469-925-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-09-29 |