| NPI | 1376646117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Director 401-765-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: PA PP412896L) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-01-31 |