| NPI | 1467598110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL GOMEZ Pharmacist In Charge 330-757-4033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-03-21 |