| NPI | 1871168229 |
|---|---|
| Doing Business As | VITASOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SHAILENDRA GUPTA Officer 844-843-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-05-26 |