| NPI | 1558738864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW GLOVER VP & Gm Specialty Pharmacy Dist 612-777-4940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: FL PH19541) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2024-09-16 |