| NPI | 1659837615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGIL DAVIS Chief Executive Officer 928-289-4646 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2025-12-01 |