| NPI | 1497790406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBERT Sr. Director, Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator |
| 261QM2500X Clinic/Center Medical Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 054014198) | |
| 333600000X Pharmacy (Licence: IL 054014198) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-06-26 |