| NPI | 1699022798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK TWITCHELL Registered Pharmacist 505-820-2196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NM RP00007845) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |