| NPI | 1548944051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD MANNING Owner/PIC 937-350-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-06-14 |