Healthcare Provider Details

I. General information

NPI: 1538732730
Provider Name (Legal Business Name): ARROWHEAD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 W BELL RD STE 200A
GLENDALE AZ
85308-3878
US

IV. Provider business mailing address

5625 W BELL RD STE 200A
GLENDALE AZ
85308-3878
US

V. Phone/Fax

Practice location:
  • Phone: 623-680-2157
  • Fax:
Mailing address:
  • Phone: 623-680-2157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TARAN GOODBALLET
Title or Position: PIC
Credential: PHARMD
Phone: 623-680-2157