| NPI | 1629223250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN E SWINTON Credentialing Director 301-257-2797 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy (Licence: VA 0201004261) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2025-07-25 |