| NPI | 1720796402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINGSLEY IWUDIBIA Owner 508-315-2769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 251F00000X Home Infusion |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2024-02-01 |