| NPI | 1083982896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEL DIENNET Owner 1310-277-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: CA 44310) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2023-03-07 |