| NPI | 1649706714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN ENERIAKPOZI EZEKIEL Phjarmacist In Charge 414-698-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9459-42) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |