| NPI | 1194135103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER PETROV President 480-625-4750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AZ Y005900) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy (Licence: AZ Y005900) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-08-21 |