| NPI | 1417310178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIEN NICHOLAS BOYD Co Owner 316-613-8942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy (Licence: KS 2-13252) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2022-06-15 |