| NPI | 1720251564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW C WALK CEO 833-765-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: NE 2811) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NE 2811) |
| 333600000X Pharmacy (Licence: NE 2811) | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: NE 2811) | |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2024-09-19 |