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General NPI Number Information
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NPI Number | 1376558999
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Entity Type | Organization
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Legal Business Name | WILLO PHARMACY
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 12339 E POINSETTIA DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-3322
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Country | US
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Telephone | 480-860-6866
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Fax | 480-860-6051
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Provider Business Mailing Address
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Address Line | 12339 E POINSETTIA DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-3322
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN WEBER
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Credential | RPH
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Telephone | 480-860-6866
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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 | Y035575
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License Number State | AZ
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