NPI | 1104967918 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA OS012672) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2012-12-04 |