| NPI | 1558231837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIBROAD AMINAZONG Owner 520-561-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2026-02-10 |