| NPI | 1578029849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISA DAVYDOVA Managing Member 862-772-0442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2024-02-29 |