Healthcare Provider Details

I. General information

NPI: 1649281213
Provider Name (Legal Business Name): CIVIC CENTER PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 E OSBORN DR
SCOTTSDALE AZ
85251-6435
US

IV. Provider business mailing address

7331 E OSBORN DR #208
SCOTTSDALE AZ
85251-6435
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-9519
  • Fax: 480-275-7812
Mailing address:
  • Phone: 480-945-9519
  • Fax: 480-278-7812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN CHRISTOPHER MURPHY
Title or Position: VP/SECRETARY/MANAGER
Credential:
Phone: 305-808-9838