| NPI | 1679616692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NJ RS004377) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2010-08-12 |