| NPI | 1396264305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CANONIC Senior Director, Enrollment 480-853-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL PH31109) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2025-06-11 |