| NPI | 1851348643 |
|---|---|
| Doing Business As | INDIO MEDICAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | WAYNE KAN Pharacist Owner 760-347-0659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY21267) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2016-12-08 |