| NPI | 1699929075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOORE PIC 703-491-6802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2010-02-10 |