| NPI | 1376264499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW C WALK CEO 833-765-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2023-07-10 |