| NPI | 1073655379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: RI MD13369) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-11-07 |