NPI | 1609095868 |
---|---|
Doing Business As | BONNEVILLE LTC |
Entity Type | Organization |
Authorized Contact | ROBERT NETHERCOTE President 508-450-3161 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: CT 2085) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2010-06-09 |