| NPI | 1295900041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTRY SETSER CEO 805-214-0915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL AW2583145) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-06-16 |