| NPI | 1871967315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MICHAEL CHAN Pharmacist In Charge 909-285-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: CA 63648) |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: AZ 006449) |
| 3336M0002X Pharmacy Mail Order Pharmacy (Licence: NV 03414) | |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |