| NPI | 1386187474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BORELL Owner 866-567-1642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: PA PP482173) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2020-02-13 |