| NPI | 1962681858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FIGUEROA RIVERA Third Party Administrator 732-521-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2010-08-11 |