| NPI | 1174808398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE Sr Director Ops 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA OS010436L) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2012-10-23 |