NPI | 1588897607 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY CANONIC Senior Director, Enrollment 480-853-0515 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY50034) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2009-08-25 |
Last Update Date | 2025-06-17 |