| NPI | 1811375769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CALKINS Owner 440-544-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NM MD2011-0247) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |