NPI | 1184767022 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: RI MD06986) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2012-10-17 |