| NPI | 1972539195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WAGNER President 619-464-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY38149) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2008-07-03 |