| NPI | 1619524766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDE P JEAN-PIERRE CEO 920-470-7480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-09-01 |