| NPI | 1083099485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ULFAT U NISA Officer 855-355-3552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 30072) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2016-11-29 |