| NPI | 1891158440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER STEVEN POKRASS Pharmacist 480-452-9121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 18051-40) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 051299124) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |