| NPI | 1891108528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA PP482463) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2015-11-09 |