| NPI | 1568196038 |
|---|---|
| Doing Business As | YSLETA DEL SUR PUEBLO PHARMACY |
| Entity Type | Organization |
| Authorized Contact | REASOL A CHINO Director 915-858-1076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2023-07-05 |