NPI | 1538694955 |
---|---|
Entity Type | Organization |
Authorized Contact | LUDOVICK YOUMBI Pharmacist In Charge 866-293-1559 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
3336L0003X Pharmacy, Long Term Care Pharmacy | |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2017-04-23 |
Last Update Date | 2020-11-11 |