| NPI | 1821409251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operation 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NC 31742) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |