| NPI | 1396297321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED TAWADROUS Owner 856-581-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MA07842400) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-12-02 |