| NPI | 1568718856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SUTTON Executive Director 888-908-8148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: TX 28323) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2016-12-08 |