| NPI | 1346352036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANCY WALTER President 307-532-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WY 52-03497) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-04-15 |