| NPI | 1003500158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OBIAGELI LISA MOMODU Managing Pharmacist 702-480-6221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-09-12 |