| NPI | 1669498515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN EUGENE BURR Secretary 712-310-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-12-04 |