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General NPI Number Information
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NPI Number | 1124116900
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Entity Type | Organization
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Legal Business Name | RALEY'S ARIZONA LLC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 1761 E WARNER RD
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City | TEMPE
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State | AZ
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Zip | 85284-4558
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Country | US
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Telephone | 480-897-2980
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Fax | 480-879-2964
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Provider Business Mailing Address
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Address Line | PO BOX 488
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City | CHANDLER
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State | AZ
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Zip | 85244-0488
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Country | US
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Telephone | 480-895-5372
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Fax | 480-895-5371
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | MIKE MCKINLEY
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Credential |
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Telephone | 480-895-5372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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