is a Long Term Care Pharmacy in , . practices all healthcare services and medical treatments related to Long Term Care Pharmacy. The NPI Number for is 1609926500. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1609926500 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Long Term Care Pharmacy |
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| Taxonomy | 3336L0003X |
| Licence No | PHRE003436 |
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Definition: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregat |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00032744A | GA | -- |
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