| NPI | 1740340983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN SWINTON Credentialing Director 301-257-2797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: VA 0201004121) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-10-10 |