| NPI | 1346332970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GENE PEDRI Pharmacist In Charge Owner 307-382-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: WY 52-03156) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-03-09 |