| NPI | 1316621055 |
|---|---|
| Doing Business As | 986 PHARMACY #8017 |
| Entity Type | Organization |
| Authorized Contact | ROBERT J OJEDA CEO 702-818-8182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2023-06-13 |
| Last Update Date | 2024-03-25 |