| NPI | 1518642644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VITTELIAN FORBES Owner 602-237-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-06-16 |