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General NPI Number Information
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NPI Number | 1154759603
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALTHCARE LLC
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Dates
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Enumeration Date | 10/18/2013
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 3361 W GREENWAY RD STE.2
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City | PHOENIX
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State | AZ
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Zip | 85053-7641
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Country | US
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Telephone | 602-993-0766
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Fax | 602-993-0768
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Provider Business Mailing Address
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Address Line | 3361 W GREENWAY RD STE.2
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City | PHOENIX
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State | AZ
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Zip | 85053-7641
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Country | US
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Telephone | 602-993-0766
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Fax | 602-993-0768
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Authorized Official
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Title or Position | MANAGER, PIC
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Name | BABATUNDE GHANNI
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Credential | PHARM D
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Telephone | 602-993-0766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y005773
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License Number State | AZ
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