Healthcare Provider Details

I. General information

NPI: 1093554495
Provider Name (Legal Business Name): LEMED SPECIALTY PHARMACY ARIZONA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E GUADALUPE RD STE 110
GILBERT AZ
85234-5116
US

IV. Provider business mailing address

2417 3RD AVE STE 406
BRONX NY
10451-6340
US

V. Phone/Fax

Practice location:
  • Phone: 800-347-1137
  • Fax: 718-231-2727
Mailing address:
  • Phone: 347-913-4656
  • Fax: 718-231-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHALEEN PATEL
Title or Position: CEO
Credential:
Phone: 347-913-4356