| NPI | 1366127748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN-DAVID COLLIER Compliance Officer 210-887-7503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-06-21 |