| NPI | 1497156111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SREEDEVI MANDALAPU Member 610-419-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2015-09-22 |