| NPI | 1033185186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P DEHAEMERS Dir, Pharmacist In Charge 959-299-2941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2003001979) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-03-07 |