| NPI | 1891132999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SCOTT LATTOS Pharmacist/Owner 608-519-4622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: WI 9198-42) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |