Healthcare Provider Details

I. General information

NPI: 1457236614
Provider Name (Legal Business Name): PINNACLE COMPOUNDING PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 W PINNACLE PEAK RD STE 120-B
GLENDALE AZ
85310-4005
US

IV. Provider business mailing address

27018 N 64TH DR
PHOENIX AZ
85083-7416
US

V. Phone/Fax

Practice location:
  • Phone: 623-692-7033
  • Fax:
Mailing address:
  • Phone: 623-692-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHREENA GOVANI
Title or Position: PHARMACIST
Credential:
Phone: 623-692-7033