| NPI | 1750251682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASIHUN BERHE NICODIMOS Pharmacist/Manager 505-402-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2025-11-06 |