| NPI | 1104127851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANESH R BALU President 302-734-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: DE DEA BB6016403) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |