| NPI | 1639165459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BAACH Secretary 856-823-1574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: NY 023601) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2024-05-29 |