| NPI | 1235462342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Opertions 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NC 200300353) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2015-07-27 |