| NPI | 1528441417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R PERROU Owner 360-888-0955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-04-02 |