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 |