| NPI | 1598002255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD031932E) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |