| NPI | 1871783324 |
|---|---|
| Doing Business As | SUPER DRUG MART #5 |
| Entity Type | Organization |
| Authorized Contact | RAYMOND D IBANEZ President 210-674-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 25658) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |