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A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO?s covered members only.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1235612920 |
| Entity | Organization |
| Organization subpart 1 | Not specified |
| Enumeration date | 09/10/2018 |
| Last updated | 09/10/2018 - About 8 years ago |
| Identifiers | n/a |
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GERALD M BONKO
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GERALD M BONKO, RPH