| NPI | 1538497235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN SCORSATTO Pharmacist In Charge 877-616-6247 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CA phy50129) |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: CA phy50129) |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CA PHY50129) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: CA phy50129) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA phy50129) | |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2015-07-10 |