| NPI | 1689440604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MITCHELL CEO 219-465-9503 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2024-01-12 |