NPI | 1558508267 |
---|---|
Doing Business As | EXCELA CHESTNUT RIDGE WELDON STREET |
Entity Type | Organization |
Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD033840) |
Enumeration Date | 2009-01-16 |
Last Update Date | 2012-10-23 |