| NPI | 1659647170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHNSON Outpatient Pharmacy Manager 740-542-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OH SP022178500) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2017-03-20 |