| NPI | 1376683284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEORA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT PCY0000033) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2018-12-17 |