| NPI | 1407618168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MICHAEL MCMAHON Pharmacy Manager 877-241-9002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |