| NPI | 1902212830 |
|---|---|
| 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: DE A3-0000895) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2018-06-05 |