| NPI | 1558580241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ALAN PERSONS Pharmacist In Charge 877-678-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: AZ 4076) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AZ 4076) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2025-06-13 |