NPI | 1164809778 |
---|---|
Doing Business As | CREDENA HEALTH PHARMACY LAKESHORE |
Entity Type | Organization |
Authorized Contact | MIKE SKAFI A VP/Secretary 575-650-3396 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2015-05-04 |
Last Update Date | 2023-12-07 |