| NPI | 1376688655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S GOLD VP, Assistant Secretary 1413-504-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT PENDING) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT PCY.2078) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2015-12-15 |