| NPI | 1386155752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN CROMWELL Owner 949-355-5766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CA 4043876) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |