| NPI | 1700242740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUSSEF KHALIFA Pharmacy Supervisor 319-610-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60570288) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |