| NPI | 1275740474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIC PERINI Assistant Secretary 314-684-6924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 3946) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-07-02 |