| NPI | 1568640928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY RENZ Owner 307-472-0597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: WY 52-03586) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2010-10-06 |