| NPI | 1073695854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY PRUNTY President 301-758-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WV SP0552272) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-17 |