| NPI | 1558712364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT LEGOWSKI Operations 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 35094501) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |