| NPI | 1962092510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY BLICK Authorized Official, Director 203-345-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-02-25 |