| NPI | 1720364532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN EUGENE BURR Secretary 712-310-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2024-09-16 |