| NPI | 1952847220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BANKS Managing Member 440-816-5380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 3565801) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-02-07 |