| NPI | 1740550334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FITE Pharmacy Manager 812-450-3780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336I0012X Pharmacy Institutional Pharmacy (Licence: IN 60001691A) | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2016-12-14 |