Healthcare Provider Details
I. General information
NPI: 1467467084
Provider Name (Legal Business Name): OP PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1275 W WASHINGTON ST STE 105
TEMPE AZ
85281-1859
US
IV. Provider business mailing address
805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7101
US
V. Phone/Fax
- Phone: 480-240-1111
- Fax: 480-240-1112
- Phone: 502-627-7100
- Fax: 855-271-7498
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 4342 |
| License Number State | AZ |
VIII. Authorized Official
Name:
ALLISON
BROWN
Title or Position: SECRETARY/MANAGING MEMBER
Credential:
Phone: 502-627-7100