NPI | 1932437746 |
---|---|
Doing Business As | PEAK VISTA PHARMACY AT MYRON |
Entity Type | Organization |
Authorized Contact | TRACY NARVET CFO 719-344-6188 |
Organization Subpart ? | Yes |
Primary Taxonomy | 333600000X Pharmacy (Licence: CO 789) |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
Enumeration Date | 2009-12-07 |
Last Update Date | 2018-08-17 |