| NPI | 1730933607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGON-VINCENT VAN Pharmacist In Charge 888-648-1134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-04-17 |