| NPI | 1104160712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWAME HANSON President 301-233-4542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MD P05807) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD P05807) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |