| NPI | 1871949198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LEGOWSKI Operations 609-703-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH 36002419) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |