| NPI | 1154775989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME VONGLAHN Pharmacy Coordinator 520-325-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ I011747) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |