| NPI | 1285242438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLE GOSSAN Pharmacist In Charge 210-517-6556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-08-10 |