| NPI | 1952328155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CANONIC Senior Director, Enrollment 480-853-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: VA 0201002947) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-07-07 |