| NPI | 1659859965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAKSOO KIM Owner 385-450-0747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: UT 10901846-1703) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2021-01-20 |