| NPI | 1902189202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN BENNETT Pharmacy Manager 317-462-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 26021196A) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |