| NPI | 1801375506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY M VU Pharmacist 267-282-5747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA PP482807) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2019-11-22 |