| NPI | 1093501975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE R HERNANDEZ ABELENDA Manager Member 702-000-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-04-16 |