| NPI | 1891724860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK HARRIS Managed Care Analyst 623-869-3778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 54013011) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |