| NPI | 1407163736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIC PERINI Assistant Secretary 314-684-6273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA 50860) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2021-04-08 |