| NPI | 1114078110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PETERS Phrm 209-475-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY46901) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-26 |