| NPI | 1043760135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT LEGOWSKI Operations 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD023823E) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |