| NPI | 1396526661 |
|---|---|
| Other Name | HYDE PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | KENNETH KUENZEL Owner 870-239-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2024-03-15 |