| NPI | 1689819526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE NEIL Director Of Pharmacy Services 866-221-6588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2008-12-05 |