| NPI | 1740091271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALECIA RAUCH Paralegal 608-729-1658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |