| NPI | 1609129329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MA02738600) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-25 |