| NPI | 1255714713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND MARTINEZ Pharmacist 505-314-4933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NM 183500000x) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |