Healthcare Provider Details
I. General information
NPI: 1568308310
Provider Name (Legal Business Name): MEDISTAR HEALTHCARE CONNECTIONS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3770 N 7TH ST
PHOENIX AZ
85014-5022
US
IV. Provider business mailing address
3770 N 7TH ST
PHOENIX AZ
85014-5022
US
V. Phone/Fax
- Phone: 602-337-5707
- Fax:
- Phone: 602-337-5707
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
INI
AKPABIO
Title or Position: CEO
Credential:
Phone: 602-337-5707