| NPI | 1619417284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BEISTEL Owner 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 34009942) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |