| NPI | 1912255274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOOTAN MELAMED PIC 888-367-3092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NV PH02853) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |