| NPI | 1851791529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DAVILA Owner 219-924-9540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 60006396a) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2020-03-02 |