NPI | 1104097054 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OR MD14262) |
Enumeration Date | 2008-03-19 |
Last Update Date | 2012-10-22 |