| NPI | 1740217678 |
|---|---|
| Doing Business As | PROMEDICA OUTPATIENT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BRYAN COEHRS System Director, Community Pharmacy 567-585-3041 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OH 020541450) |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 3336I0012X Pharmacy, Institutional Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2025-09-15 |