| NPI | 1639626807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATHA THIMMASANDRA CHANDRASHEKARIAH Member 917-962-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |