| NPI | 1457164535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDIA TERESA DICKINSON Owner 602-705-1136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-07-23 |