NPI | 1619498300 |
---|---|
Entity Type | Organization |
Authorized Contact | JAVIER PONCE Owner 973-482-7007 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MD00246800) |
Enumeration Date | 2017-07-03 |
Last Update Date | 2019-05-22 |