Healthcare Provider Details

I. General information

NPI: 1437327244
Provider Name (Legal Business Name): CARESITE PHARMACY OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 EAST BELL RD
PHOENIX AZ
85032
US

IV. Provider business mailing address

100 N ACADEMY AVE MC 24-15
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-7965
  • Fax:
Mailing address:
  • Phone: 570-271-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number4962
License Number StateAZ

VIII. Authorized Official

Name: JAMES M MESSINA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 570-271-7285