| NPI | 1326756057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAEN SIDHOM Rx Manager 301-321-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2025-06-18 |