| NPI | 1982368171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAHSIN SHANAN Owner 257-204-9605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-12-03 |