| NPI | 1073660122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARREEN HUFFMAN Adminstrator 301-571-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MD D0029675) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-06-28 |