| NPI | 1508853045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY J FERGUSON Compliance Officer 765-662-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IN 26015280A) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-09-15 |