| NPI | 1902167596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AREN LEIGHTON Vice President 833-383-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA 89815) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2020-05-15 |