| NPI | 1003354432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALOYSIUS IBE President 443-798-0556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MD P07422) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-09-01 |