Healthcare Provider Details

I. General information

NPI: 1104720994
Provider Name (Legal Business Name): PHARMA-LABS FINANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10645 N TATUM BLVD STE 200-479
PHOENIX AZ
85028-3068
US

IV. Provider business mailing address

1913 S MINTLE ST TRLR 42
AIRWAY HEIGHTS WA
99001-5262
US

V. Phone/Fax

Practice location:
  • Phone: 501-476-4559
  • Fax: 870-888-0627
Mailing address:
  • Phone:
  • Fax: 870-888-0627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: TODD STOTTLEMYRE
Title or Position: MANAGER
Credential:
Phone: 501-476-4559