| NPI | 1366546319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY J WARREN President 765-828-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 60005617A) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2026-01-22 |