| NPI | 1104295054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHENA PETERSON Pharmacist 203-217-1562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 0013072) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-09-22 |