| NPI | 1659972230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER ROPER Licensing And Credentialing Analyst 623-340-9721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2023-02-27 |