| NPI | 1437229515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MEDICI Controller 949-640-1231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY20283) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-01-12 |