| NPI | 1174399364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SHAW Owner 973-647-9172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2023-11-28 |