| NPI | 1114031002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS ONG Rph 916-487-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY43141) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |