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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 # | 1215066949 |
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| LBN Legal business name | FORT WAYNE MEDICAL ONCOLOGY & HEMAT | ||||||||||||
| Authorized official | TRACY MARAVILLA - (PHARMACY DIRECTOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 03/06/2007 | ||||||||||||
| Last updated | 05/03/2010 - About 16 years ago | ||||||||||||
| Identifiers |
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FORT WAYNE MEDICAL ONCOLOGY & HEMAT