| NPI | 1649256785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GLICK President 808-245-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: HI PHY 495) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: HI PHY495) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-01-07 |