| NPI | 1538469267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A COSTON Manager 480-246-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: NV 2000035-424) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 333600000X Pharmacy (Licence: NV 200035-424) | |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |