| NPI | 1851484281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED CLARK Pharmacist 510-522-3066 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CA PHY170130) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2008-07-09 |