| NPI | 1295989168 |
|---|---|
| Other Name | NORTHSIDE SAMPLE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MATTHEW NAGY Pharmacy Director 505-841-1872 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: NM CL00010555) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-05 |