| NPI | 1255720710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BANKER CEO 215-850-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA 8000002643) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |