| NPI | 1659939171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALLEN ROE Pharmacy Manager/Delegated Official 602-607-5094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2020-02-04 |