| NPI | 1811241110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIR BASSILI DEIBO Manager 818-203-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 8) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CA 87411) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2022-07-21 |