| NPI | 1770117509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE R DE TERREFORTE-DIAZ Chief Executive Officer 939-545-0522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2022-04-13 |