Healthcare Provider Details

I. General information

NPI: 1437282142
Provider Name (Legal Business Name): ZION'S RX FORMULATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6047 E UNIVERSITY DR
MESA AZ
85205-7517
US

IV. Provider business mailing address

6047 E UNIVERSITY DR
MESA AZ
85205-7517
US

V. Phone/Fax

Practice location:
  • Phone: 480-854-3100
  • Fax: 480-854-3156
Mailing address:
  • Phone: 480-854-3100
  • Fax: 480-854-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number3856
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. TROY ALBERT ALBRIGHT
Title or Position: OWNER
Credential: RPH
Phone: 480-854-3100