NPI | 1548033038 |
---|---|
Doing Business As | BLU LANE PHARMACY |
Entity Type | Organization |
Authorized Contact | T'ANDRA AUBREY Managing Officer 346-516-1798 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2023-11-06 |
Last Update Date | 2023-12-18 |