| NPI | 1518562768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LYNCH Director Of Regulatory Services 866-290-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2022-04-11 |