| NPI | 1164285110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLINA CHULPAEFF Secretary/CFO 951-530-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-02 |