| NPI | 1821584343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HOFF Owner 262-542-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: 4015-42) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |