| NPI | 1376952275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LINDSLEY President 855-416-6826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335G00000X Medical Foods Supplier |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |