| NPI | 1497280549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM AUSTIN Director 888-980-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-05-09 |