| NPI | 1578667523 |
|---|---|
| Doing Business As | MOORES LAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | VENKATA MUDUNURI Rph In Charge 302-697-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: DE A30000937) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-09-13 |