NPI | 1073758157 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OR MD28172) |
Enumeration Date | 2008-12-03 |
Last Update Date | 2018-12-03 |