| NPI | 1609433085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY L CAMPA Sr. Consultant Payer Relations 909-799-4174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |