| NPI | 1619097961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON WADHAMS Pres 928-774-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AZ Y004735) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2018-07-19 |