| NPI | 1912450537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DEROSA District Manager 781-391-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA ph236655) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |