| NPI | 1629028378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT LOUDERBACK President 402-489-1135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF00057982) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2009-02-20 |