| NPI | 1134263296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM AUSTIN Director 888-980-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AL 101698) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AL 101698) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2017-10-10 |