| NPI | 1891591913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY BLICK Medical Director 203-345-0404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |