| NPI | 1053326660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DONATHEN Gm 714-523-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY47292) |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |