| NPI | 1194761585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ROOTSAERT President 559-760-2934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: UT 60531781703) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-02-20 |