| NPI | 1356362313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FLINT Owner 608-310-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WI 9504-42) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2018-06-12 |