| NPI | 1750701066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M RALSTON System Director 419-996-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: VA 0201004574) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2022-05-18 |