| NPI | 1316997083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMECK NYAKWEBA Owner 602-430-9646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AZ Y004448) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2010-11-01 |