| NPI | 1053858480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EGHOMWARE IGBINOVIA Owner 702-800-6448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: NV PH03673) |
| Additional Taxonomies | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| 333600000X Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |