| NPI | 1134466261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 35070971) |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2013-01-09 |