| NPI | 1528073129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COLBERT Sr Director, Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: VA 0201002901) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2019-11-26 |