| NPI | 1609326362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ELIAS Owner 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA SC004352L) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-11-22 |