| NPI | 1396144911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SACHOY FOWLER Pharmacist 256-289-5972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NJ 28ri03562400) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |