| NPI | 1013936285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M CUETO Managed Care Operations Manager 925-210-6660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF56697) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |