| NPI | 1871839043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFRED O CHAVEZ Owner/Pharmacist 505-864-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NM ph00002408) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: NM 4411640001) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2012-12-17 |