| NPI | 1144635087 |
|---|---|
| Doing Business As | COSTELLO AND COSTELLO MDS |
| Entity Type | Organization |
| Authorized Contact | SCOTT PETERSON CFO 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NY 149866) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-01-13 |