| NPI | 1255103024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL TATERA Managing Member 702-800-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-10-31 |