| NPI | 1720360852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHARLES KISTNER Pharmacist 760-949-8930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 63864) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2011-09-14 |