| NPI | 1427004449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEON OTERO Managing Member/Owner 505-869-3646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NM 2411) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-08-22 |