| NPI | 1417240367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH DEWAN Owner 267-331-5421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP487141) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |