| NPI | 1912425109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHOK POTHULA Manager 505-268-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NM PH00004510) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2017-09-07 |