| NPI | 1306940283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Director Phcy Enrollments 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL PH21399) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-12-04 |