NPI | 1972663102 |
---|---|
Doing Business As | DAVITA MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH19244) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2006-12-11 |
Last Update Date | 2019-08-19 |