| NPI | 1497801047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN NORRIS CFO 505-757-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NM 6263) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: NM cl00007120) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2015-09-22 |