| NPI | 1942942610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CLARK Partner 602-653-7940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |