| NPI | 1538602511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KONAK VP, Revenue Cycle Mgt 877-662-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: MA DS89702) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2025-07-24 |