| NPI | 1174312383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GELANIE REGASSA Pharmacy Manager 202-990-8430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |