| NPI | 1578709002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RAZO Director Of Contracts And Licensing 602-258-6797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC5153) |
| Additional Taxonomies | 251S00000X (Licence: AZ OTC-5153) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2024-06-07 |