| NPI | 1487298881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DAWN CICCOLELLA-KAHL President, Director 800-511-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2024-05-22 |