| NPI | 1053847293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA FAYE FRANK Credentialing Coordinator 703-208-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VA 0201004756) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2024-08-14 |