| NPI | 1114381886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GOLDIS Owner 856-346-3469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MB05768800) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |