| NPI | 1598224586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GUIRGUS Pharmacist 862-772-3871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |