| NPI | 1811328560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHALIE T. ALFONSO Medical Director 480-882-9105 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: AZ AP4940) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |