| NPI | 1003401134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DOUGE Pharmacy Manager 267-959-7277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2026-08-20 |