NPI | 1003251638 |
---|---|
Entity Type | Organization |
Authorized Contact | CRYSTAL CONTRERAS Billing 801-359-2256 |
Organization Subpart ? | No |
Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: UT 8547079-1704) |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
Enumeration Date | 2013-05-09 |
Last Update Date | 2017-12-21 |