| NPI | 1609882083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA GARNETT Program Supervisor Vi 512-913-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336I0012X Pharmacy Institutional Pharmacy |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-11-08 |