NPI | 1770744583 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD L JOHNSON Owner 307-472-0597 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: WY 5282609A) |
Enumeration Date | 2008-06-24 |
Last Update Date | 2008-06-24 |