| NPI | 1972893634 |
|---|---|
| Doing Business As | COMMUNITY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANTHONY AFAMEFUNA OKONKWO Member 267-809-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 34222) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TN 34222) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2012-02-17 |