| NPI | 1508057340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANNE RENE SEDA Practice Operations Liaison 410-484-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332100000X Department of Veterans Affairs (VA) Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2012-06-18 |