| NPI | 1245445071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WILBUR P.A. 775-863-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2025-10-15 |