| NPI | 1043197080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PITCHER Pharmacist In Charge, Pharmd 505-677-8842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |