| NPI | 1174151716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YODIT GULELAT Owner/Manager 703-348-7186 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-11-20 |