| NPI | 1710672456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEO BLAISE RUKUNDO Managing Director 857-247-8763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |