Healthcare Provider Details
I. General information
NPI: 1437408085
Provider Name (Legal Business Name): CAREFREE COMPOUNDING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2012
Last Update Date: 12/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34975 N NORTH VALLEY PARKWAY STE 130
PHOENIX AZ
85086
US
IV. Provider business mailing address
34975 N NORTH VALLEY PARKWAY STE 130
PHOENIX AZ
85086
US
V. Phone/Fax
- Phone: 623-806-1300
- Fax: 623-806-1304
- Phone: 623-806-1300
- Fax: 623-806-1304
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH03198 |
| License Number State | NV |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | NRP-1857 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | Y005524 |
| License Number State | AZ |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 9108264-1708 |
| License Number State | UT |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH00003709 |
| License Number State | NM |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | NR-51159 |
| License Number State | WY |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | NR-51159 |
| License Number State | WI |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | OSP.0006485 |
| License Number State | CO |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LORICA
KAY
YOCKEY
Title or Position: PHARMACIST IN CHARGE
Credential: PHARM D.
Phone: 623-806-1300