| NPI | 1487036521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAM TRUONG Owner 267-969-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP482557) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |