| NPI | 1033522370 |
|---|---|
| Other Name | DV-202 |
| Entity Type | Organization |
| Authorized Contact | CLAUDIA GRIJALVA Credentialing 623-241-6152 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |