| NPI | 1396011888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HUTERA Owner 765-463-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IN 60006301A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2022-05-25 |