| NPI | 1699104372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DONTSOV Managing Member 818-687-7368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP0002838CS) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |