| NPI | 1457064388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMBELLI OKUNADE Contracting And Credentialing Analy 617-414-0536 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |