| NPI | 1205182870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGOC T CHUNG Pharmacist/Store Manager 267-343-8741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2013-09-19 |