| NPI | 1811039050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PETERSON CFO 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MN 32793) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-04-11 |