| NPI | 1275657074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE BERMAN Executive Director Of Pharmacy 602-914-1813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ 4147) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-10-03 |