| NPI | 1912373358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN HAYWOOD Owner/Manager 812-457-1204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: IN 26020577) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |