| NPI | 1669891842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D. WEESE Pharmacy Manager 623-326-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ S019270) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |