| NPI | 1528362076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DAWN CICCOLELLA-KALH President 800-511-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301010710) |
| Additional Taxonomies | 251F00000X Home Infusion |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy (Licence: MI 5301010710) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: MI 5301010710) | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2024-02-09 |