| NPI | 1902942519 |
|---|---|
| Doing Business As | PROFESSIONAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DILLARD IRBY Pharmacist And Owner 575-585-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NM PH00001186) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2011-04-12 |