| NPI | 1700249869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE TIMMINS Credentialing/Contracting Specialis 603-882-3616 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-11-16 |