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General NPI Number Information
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NPI Number | 1316264716
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Entity Type | Organization
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Legal Business Name | BNR HEALTHCARE CORP
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 2222 S DOBSON RD BLDG 9
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City | MESA
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State | AZ
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Zip | 85202-6481
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Country | US
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Telephone | 480-253-3100
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Fax | 480-497-3784
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Provider Business Mailing Address
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Address Line | 2222 S DOBSON RD BLDG 9
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City | MESA
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State | AZ
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Zip | 85202-6481
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Country | US
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Telephone | 480-253-3100
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Fax | 480-497-3784
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRED ISKHAKOV
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Credential |
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Telephone | 480-253-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | Y005662
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License Number State | AZ
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