| NPI | 1962500595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Director, Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 023536) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-08-04 |