| NPI | 1962406850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DAWN CICCOLELLA-KAHL President 800-511-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 251F00000X Home Infusion |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2024-02-09 |