| NPI | 1558859710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MICHELLE RODRIGUEZ Pharmacist 505-862-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: NM PH00004616) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |