| NPI | 1750533725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP481881) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2018-12-20 |