| NPI | 1437674173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANA PEKAREVA Owner 267-255-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: PA PP482773) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2019-02-13 |