| NPI | 1992127682 | 
|---|---|
| Doing Business As | ACACIA APOTHECARY AND WELLNESS | 
| Entity Type | Organization | 
| Authorized Contact | JUSTIN MATTHEW BROCK Manager 520-405-7651 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ Y005818) | 
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy | 
| Enumeration Date | 2014-01-14 | 
| Last Update Date | 2022-09-12 |