| NPI | 1467985689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WELKER Managing Member 724-225-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD417097) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |