| NPI | 1821631672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIHRETEAB TEWOLDE TEWOLDE Pharmacy Manager 319-341-9008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2020-10-01 |