| NPI | 1194138545 |
|---|---|
| Other Name | PEORIA |
| Entity Type | Organization |
| Authorized Contact | CLAUDIA GRIJALVA Credentialing 623-241-6152 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |