| NPI | 1467739946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD021236E) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2014-01-03 |