| NPI | 1124213640 |
|---|---|
| Doing Business As | PRESCRIPTION LAB COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY NICOLETTI President 520-886-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ Y02793) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |