| NPI | 1851404602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RAY GLOOR President/Board Of Directors 308-389-5623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332100000X Department of Veterans Affairs (VA) Pharmacy |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: NE 80) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |