| NPI | 1962726059 |
|---|---|
| Other Name | AVELLA OF DEER VALLEY-SECOND |
| Entity Type | Organization |
| Authorized Contact | DAVID OBERG Assistant Secretary 952-936-1300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: AZ Y005084) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2018-11-14 |