| NPI | 1255591418 |
|---|---|
| Doing Business As | HAVASU HEALTH CARE PHARM |
| Entity Type | Organization |
| Authorized Contact | KELLY DAHLBERG Owner 928-855-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: AZ Y0004984) |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |