| NPI | 1689116402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BORER President 712-243-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: IA 54) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2020-07-16 |