| NPI | 1154778199 |
|---|---|
| Doing Business As | LIVE OAKS OCTAGON, LLC |
| Entity Type | Organization |
| Authorized Contact | TOM MULLEN Manager 646-729-7578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-08-02 |