| NPI | 1922029362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT DINO CEO/Owner 800-947-2711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IN 60006593A) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2017-03-27 |