| NPI | 1366587461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 731-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NJ RS003323) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2026-05-01 |