| NPI | 1659459162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HAMMOND Third Party Admin 614-481-4272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |