| NPI | 1376186643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY THANH NGUYEN PIC 682-320-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2019-10-19 |
| Last Update Date | 2020-04-13 |