| NPI | 1962055004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWUN HEUN BRIAN LEUNG Pharmacy Supervisor 401-769-4100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-12-23 |