| NPI | 1780030163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MCCABE Secretary 820-245-4968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 251F00000X Home Infusion | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2026-05-26 |