| NPI | 1780326488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKHAIL NASKHLETASHVILI Owner 716-306-3886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2024-03-26 |