| NPI | 1912632415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYESHA WASHINGTON Owner/Managing Officer 346-754-5175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2024-04-17 |