| NPI | 1912918590 |
|---|---|
| Doing Business As | KINGMAN HOMETOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER VELEZ Mgr 928-681-4888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ 4304) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-07-21 |