| NPI | 1760757884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE Sr Director Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MA04449000) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-10-25 |