| NPI | 1407365513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L. LONGVILLE Chief Accounting Officer/Controller 216-636-7416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH30943) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2022-12-08 |