| NPI | 1629867056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL KODICEK Specialized Services Supervisor 480-662-5475 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |