| NPI | 1124318092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYRON MOON President 814-860-6338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP482110) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2016-03-08 |