| NPI | 1417978479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE HEFLEY Director Of Pharmacy 866-348-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH22190) |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2018-09-26 |