| NPI | 1588095095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERTHA LEWIS Manager 443-423-0199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |