| NPI | 1407252869 |
|---|---|
| Doing Business As | SUPERIOR LANE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ERIC A MONGO Director 240-334-2546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |