| NPI | 1972247799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LYNN CAVANAUGH Pharmacy Operations Analyst 402-552-3927 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2023-09-18 |