NPI | 1902385354 |
---|---|
Entity Type | Organization |
Authorized Contact | MACKENZIE HAHN Ncpdp Coordinator 855-296-3757 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: LA MD017658) |
Enumeration Date | 2018-08-07 |
Last Update Date | 2018-08-07 |