| NPI | 1497329718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY KRUTH Vice President Of Finance 888-331-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |