| NPI | 1376956607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEE SHELLY Pharmacist 317-289-0729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA 027304) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |