| NPI | 1962552299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOYD BALDOCK Officer And Authorized Official 615-234-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME0054890) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2019-05-06 |