| NPI | 1063971539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL THOMAS MAHFOUZ Managing Member 769-235-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-10-21 |