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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 Number | 1770656860 |
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| LBN Legal business name | ST ANTHONY WESTSIDE PHARMACY | ||||||||
| Authorized official | GARY RIEDMANN - (CEO) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 11/16/2006 | ||||||||
| Last updated | 08/22/2020 - About 6 years ago | ||||||||
| Identifiers |
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