| NPI | 1780135996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKPAUL TUAZON SANTOS CEO 928-386-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60703436) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-39878) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |