| NPI | 1306881545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADOLF NDI NGUNDAM President 703-461-3551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 0206009226) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-11-14 |