| NPI | 1528073962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN J RICHARDSON Accounting Clerk 2 641-753-4518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2009-07-22 |