| NPI | 1518031038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPAK SHAN Pres 723-277-2187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054009795) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |