| NPI | 1588924864 |
|---|---|
| Doing Business As | FOUR SQUARE, PPS |
| Entity Type | Organization |
| Authorized Contact | RICHARD WILSON President 858-336-1821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: CO PDO-843) |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: CO PDO-843) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2014-02-04 |