| NPI | 1992286298 |
|---|---|
| Former Legal Business Name | KINGMAN HOSPITAL, INC |
| Entity Type | Organization |
| Authorized Contact | TIM BLANCHARD CFO 928-681-8668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AZ Y007642) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: AZ Y007642) |
| 3336C0002X Pharmacy Clinic Pharmacy (Licence: AZ Y007642) | |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2020-07-02 |