| NPI | 1275513707 |
|---|---|
| Doing Business As | COMMUNITY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANGELA BOWEN Pharmacist In Charge 574-732-0418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IN 60004263B) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2017-04-18 |