| NPI | 1306560792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PUWO KUEMETA Pharmacist 202-450-1678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-12-06 |