| NPI | 1780793125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LIENDO Gove RN Ment Programs Manager 210-938-3182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 21165) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-09-25 |