| NPI | 1194153148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE GREEN TRONE Pharmacist 520-458-0997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AZ s020208) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |