| NPI | 1205145356 |
|---|---|
| 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 MD034451) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2016-09-15 |