| NPI | 1619912201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G BOLT Owner 301-689-9961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MD P01901) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |