| NPI | 1912424623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW C WALK CEO 833-765-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2023-07-10 |