| NPI | 1215082094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-232-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NJ RS005314) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-10-07 |