| NPI | 1023908852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL DISTEFANO President, Pharmacist In Charge 800-292-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-07-10 |