| NPI | 1114294576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINOD BOPPANA Pharmacist In Charge 410-686-0373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2019-02-27 |