| NPI | 1225306582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WARREN VOLKER Managing Partner 702-255-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NV 9581) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |