| NPI | 1427198316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT pcy1700) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2012-10-03 |