| NPI | 1437600392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON MICHAEL SCHNEIDER Owner 888-689-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TX 30984) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CO OSP.0006854) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL 30363) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: AZ Y006974) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: MO 2016042826) | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2022-10-04 |