| NPI | 1659617553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Manager Of Gov. Contracting 479-204-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT PCY.0002258) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2015-12-22 |