| NPI | 1750837852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DEMUTH Pharmacy Manager 219-680-9172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: AZ S016620) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |