| NPI | 1831839513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH TROY TATE Director 877-264-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-03-30 |