| NPI | 1821604646 |
|---|---|
| Doing Business As | IVYWILD PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SHANNON BELLE BETHEL Pharmacist/Co Owner 719-634-5541 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |