| NPI | 1891328217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE VELASQUEZ Pharmacy Dispensary Manager 702-684-1288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-02-13 |