| NPI | 1720175920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD WENDLING Owner 307-765-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WY 5202661) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2020-08-22 |