| NPI | 1457030900 |
|---|---|
| Doing Business As | VINTAGE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD ZAMANIAN Pharm.D, Rph 505-620-4352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-20 |