| NPI | 1962821694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL HANNO Pharmacy Manager 928-526-6505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: AZ S020237) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |