| NPI | 1013389535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK EIDEMILLER VP Operations 818-521-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: NV PH03447) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2018-02-07 |