| NPI | 1972613388 |
|---|---|
| Former Legal Business Name | THE BROADWAY PHARMACY |
| Doing Business As | CREDENA HEALTH PHARMACY ST. PATRICK |
| Entity Type | Organization |
| Authorized Contact | MIKE SKAFI A VP/Secretary 575-650-3396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-12-21 |