| NPI | 1871885798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KONAK VP, Reimbursement Revenue Cycle Mg 877-662-6633 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 030717) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2024-11-26 |