Healthcare Provider Details

I. General information

NPI: 1649352006
Provider Name (Legal Business Name): ESI MAIL PHARMACY SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7909 S HARDY DR SUITE 106
TEMPE AZ
85284-1112
US

IV. Provider business mailing address

7909 S HARDY DR SUITE 106
TEMPE AZ
85284-1112
US

V. Phone/Fax

Practice location:
  • Phone: 800-955-1171
  • Fax: 480-403-6372
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberY03708
License Number StateAZ

VIII. Authorized Official

Name: SUSAN PEPPERS
Title or Position: ASST. SECRETARY
Credential:
Phone: 513-858-4916