| NPI | 1760162903 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BINCY VARGHESE Corporate Compliance Officer 631-359-9711  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy | 
| Enumeration Date | 2023-07-21 | 
| Last Update Date | 2024-06-07 |