| NPI | 1982824876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA REYNE MIERA Pharmacist Advanced 505-476-8354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: NM PH00001608) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2009-09-21 |