| NPI | 1154055341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA GRACE GINES PADILLA Pharmacist In Charge 951-279-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-07-13 |