| NPI | 1518454156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKALAI LIUBENZY Officer 619-300-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: TX 31971) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2019-10-10 |