| NPI | 1447947361 |
|---|---|
| Doing Business As | VIDA DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | AWNI ALFAKHOURI CEO 909-946-6624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-04-20 |