| NPI | 1578599098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Sr. Director, Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IL 054014397) |
| 163WD0400X Registered Nurse Diabetes Educator | |
| 261QM2500X Clinic/Center Medical Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 054016228) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-07-14 |