| NPI | 1912572942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC ELIAS MILLER Director/Pharmacist In Charge 830-752-7394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-12-06 |