| NPI | 1972017671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Sr. Director Payer Relations 401-770-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2018-01-22 |