| NPI | 1750490298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ZOREK Manager Online Adjudication 717-975-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 4168) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2009-04-17 |