is a Community/retail Pharmacy in , . practices all healthcare services and medical treatments related to Community/retail Pharmacy. The NPI Number for is 1801005368. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1801005368 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
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| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Community/retail Pharmacy |
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| Taxonomy | 3336C0003X |
| Licence No | 1034 |
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Definition: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing pr |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1619519 | NCPDP |
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