| NPI | 1003227638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO CARRENO Director 888-888-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2016-07-26 |