| NPI | 1093736068 |
|---|---|
| Doing Business As | PROFESSIONAL PRESCRIPTION PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PHILENA LONG Phcy Mgr 568-426-7664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY47176) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2016-12-01 |