| NPI | 1699102046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG CONRAD Vice President 574-647-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: IN 60004143A) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2016-06-17 |