Healthcare Provider Details

I. General information

NPI: 1871865543
Provider Name (Legal Business Name): DIVERSIFIED PHARMACY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 E RANCHO VISTOSO BLVD STE 131
ORO VALLEY AZ
85755-9101
US

IV. Provider business mailing address

63717 E SADDLEBROOKE BLVD # 1
TUCSON AZ
85739-1258
US

V. Phone/Fax

Practice location:
  • Phone: 520-818-2883
  • Fax: 520-818-1833
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberY005470
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL RHOADS
Title or Position: OWNER
Credential:
Phone: 520-271-7413