| NPI | 1093051104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG PONSNES Pharmacy Manager 775-586-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 14673) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 1540361701) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2012-12-17 |