| NPI | 1760967665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN ELLERY Director, Nevada Operations 775-856-6083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |