| 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 |