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General NPI Number Information
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NPI Number | 1174294516
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Entity Type | Organization
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Legal Business Name | EPIPHANY COMPOUNDING
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 10575 N 114TH ST STE 113
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4908
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Country | US
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Telephone | 602-767-1221
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Fax | 480-781-0016
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Provider Business Mailing Address
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Address Line | 10575 N 114TH ST STE 113
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4908
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Country | US
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Telephone | 602-767-1221
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Fax | 480-781-0016
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Authorized Official
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Title or Position | PHARMACIST/MANAGING PARTNER
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Name | ASHISH PATEL
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Credential |
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Telephone | 908-565-2193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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