| NPI | 1144512187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL GERSTEIN Administrator 341-997-3740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2011012258) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |