| NPI | 1639282999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JOHN HUFFAKER Outpatient Pharmacy Manager 928-771-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ 101741) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |