| NPI | 1487459913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD PAUL WELCH Commissioner, Bg Ret Usa 860-616-3684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |