| NPI | 1982474821 |
|---|---|
| Doing Business As | MIGUEL'S PHARMACY |
| Entity Type | Organization |
| Authorized Contact | VISWA PRAKASH VARMA MANTENA Managing Member 908-745-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-10-01 |