| NPI | 1629268958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD042461L) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2014-06-23 |