| NPI | 1235519182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN THERIAULT Pharmacy Supervisor 202-731-5413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD 22466) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |