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General NPI Number Information
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NPI Number | 1346585411
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Entity Type | Organization
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Legal Business Name | QUICK PHARMACY 002 LLC
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 1105 N MESA DR
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City | MESA
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State | AZ
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Zip | 85201-3502
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Country | US
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Telephone | 602-264-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 N MESA DR
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City | MESA
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State | AZ
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Zip | 85201-3502
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Country | US
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Telephone | 602-264-9000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAHMOUD RIFAI
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Credential |
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Telephone | 937-389-0000
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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 | Y005547
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License Number State | AZ
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