| NPI | 1699425959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA MCMAHON COO 402-488-1184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2024-10-09 |