| NPI | 1437646403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZIE HAHN Ncpdp Coordinator 888-590-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH RJ170641) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |