| NPI | 1477090777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER CORDA Owner 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MB04459800) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |