| NPI | 1164565024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M PUCCINELLI Manager 408-298-6664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA pha325060) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA pha325060) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-03-06 |