| NPI | 1386627966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINE BOGNACKI Pharmacy Manager 213-742-1129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY47104) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-01-23 |