NPI | 1093952251 |
---|---|
Doing Business As | EXCELA CHESTNUT RIDGE BLAIRSVILLE |
Entity Type | Organization |
Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD026304E) |
Enumeration Date | 2009-01-09 |
Last Update Date | 2015-07-08 |