Healthcare Provider Details

I. General information

NPI: 1174033583
Provider Name (Legal Business Name): VECTRARX MAIL PHARMACY SERVICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10860 N MAVINEE DR STE 100
ORO VALLEY AZ
85737-9514
US

IV. Provider business mailing address

10860 N MAVINEE DR STE 100
ORO VALLEY AZ
85737-9514
US

V. Phone/Fax

Practice location:
  • Phone: 520-360-9641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JERALD CACCIATORE
Title or Position: PHARMACIST IN CHARGE AND OWNER
Credential: RPH
Phone: 520-405-5563