NPI: 1598315400 · EVANSVILLE, IN 47715 · Community/Retail Pharmacy · NPI assigned 09/13/2019
| Authorized Official | HAYWOOD, MARK (OWNER) |
| NPI Enumeration Date | 09/13/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 16 | $110.15 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0003A | 16 | 13 | $110.15 |