| NPI | 1124456884 |
|---|---|
| Other Name | KMART PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KELECHI A AGUWA Pharmacy Manager 240-994-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 530241688) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |