| NPI | 1538413026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1508 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD422459) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2024-04-01 |