| NPI | 1407392343 |
|---|---|
| Doing Business As | FRESH IMPERIUM PHARMACY JEFFERSON |
| Entity Type | Organization |
| Authorized Contact | PAUL GRANGER Director Of Pharmacy 717-324-4924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NJ 28RS00753600) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |