| NPI | 1639507767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRAN VENIGALLA Pharmacist 732-692-7986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2016-06-10 |