| NPI | 1730629411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARLENE BASEDOW Owner 740-532-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 34005685) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |