| NPI | 1790824092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA L LACAVICH President 143-063-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 251E00000X Home Health |
| 251F00000X Home Infusion | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-08-25 |