| NPI | 1992587935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DANIEL MAROULIS Vice President 689-263-5021 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2026-06-05 |