| NPI | 1366627770 |
|---|---|
| Doing Business As | MEDISTAT RX |
| Entity Type | Organization |
| Authorized Contact | MARK ACKER CEO 855-737-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: AL 113031) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2014-12-19 |