| NPI | 1497170252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK THOMAS CROZIER Pharmacy Director 505-589-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: NM PH00003651) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336I0012X Pharmacy Institutional Pharmacy | |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2019-10-11 |