| NPI | 1356072193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB KIBBEE CEO 833-571-7387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |