| NPI | 1124126966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTIANA MAURICIO Mgr Phcy Enrollments 401-770-2937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 54016010) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-10-08 |