| NPI | 1114415668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS CHINCHILLA Owner 888-224-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MI 5301011378) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2020-04-15 |