| NPI | 1861731382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIR D MORTAZAVI Authorized Official 877-212-8628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 28259) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2014-08-21 |