| NPI | 1548678600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L CUMMINS Pharmacist 520-293-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ S020524) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |