| NPI | 1942457205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE L BARTLETT Managed Care Plan Specialist 623-869-3524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: DC RX0800359) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2011-09-26 |