| NPI | 1760878821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASSIE LYNN VILLA Pharmacy Manager 928-377-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2019-08-12 |