NPI | 1619121308 |
---|---|
Entity Type | Organization |
Authorized Contact | COREY DOMINGER PERRY Pharmacy Technician 281-403-4474 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: DE 4526529) |
Enumeration Date | 2008-11-09 |
Last Update Date | 2008-11-09 |