| NPI | 1205201662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY DAANE Pharmacy District Coordinator 602-818-5260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ 009999) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |