| NPI | 1245239185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN J KOCHERHANS Owner 505-299-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NM PH00004054) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2021-01-29 |