| NPI | 1932718756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER ROPER Licensing And Credentialing Analyst 623-340-9721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-02-27 |