| NPI | 1417363516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT MOEN VP Of Pharmacy Operations 508-755-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA DS89925) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |