| NPI | 1942368402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE G PETERSEN Chief Financial Officer 301-816-5760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-05-27 |