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A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinic Pharmacy |
3336C0002X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1124627922 |
| LBN Legal business name | SOUTHCENTRAL FOUNDATION |
| Authorized official | RONALD OLSON - (VP OF FINANCE) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/22/2020 |
| Last updated | 10/22/2020 - About 6 years ago |
| Identifiers | n/a |
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SOUTHCENTRAL FOUNDATION