| NPI | 1699210948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON BECKER Owner 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MD00307600) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |