| NPI | 1942320718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL EUGENE HARRIS Pharmacy Supervisor 419-625-2454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: OH 02-1140700) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |