| NPI | 1437879673 |
|---|---|
| Doing Business As | PHARMACY 575 |
| Entity Type | Organization |
| Authorized Contact | MARK A POLING Owner 575-263-2908 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-08-29 |