Healthcare Provider Details

I. General information

NPI: 1265123038
Provider Name (Legal Business Name): CUREXA - WEST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 N COLORADO ST STE 109
GILBERT AZ
85233-1618
US

IV. Provider business mailing address

45 S NEW YORK RD STE 220
GALLOWAY NJ
08205-3820
US

V. Phone/Fax

Practice location:
  • Phone: 855-927-0390
  • Fax: 855-927-0392
Mailing address:
  • Phone: 855-927-0390
  • Fax: 855-927-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK KELSO TAYLOR
Title or Position: CEO
Credential:
Phone: 855-927-0390