| NPI | 1558681460 |
|---|---|
| Doing Business As | DAVITA MEDICAL GROUP, PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH24634) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2019-08-19 |