| NPI | 1972038446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDA WISA Pharmacist In Charge 732-485-9570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NJ 28RI03792000) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-04-21 |