| NPI | 1770790792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WILSON Pharmacy Director 775-574-1018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-03-07 |