| NPI | 1841064425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA L POTASNIK Credentialing COO Rdinator 304-317-7275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |