| NPI | 1902610363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITTNEY D. STEELE Pharmacist In Charge 888-705-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-03-03 |