| NPI | 1457164485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRATAP KRISHNA ANNE Pharmacy Director 209-298-1715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-01-31 |