| NPI | 1891183380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATH GARRETT HATHORN Staff Pharmacist 505-290-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NM RP00008248) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |