| NPI | 1407355480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON FLEBOTTE PIC/Authorized Official 866-209-5540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |