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General NPI Number Information
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NPI Number | 1487793121
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Entity Type | Organization
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Legal Business Name | THE APOTHECARY SHOP WHOLESALE INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 23620 N 20TH DR STE 12
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City | PHOENIX
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State | AZ
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Zip | 85085-0621
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Country | US
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Telephone | 623-434-3678
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Fax | 623-434-3651
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Provider Business Mailing Address
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Address Line | 23620 N 20TH DR STE 12
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City | PHOENIX
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State | AZ
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Zip | 85085-0621
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Country | US
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Telephone | 623-434-3650
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Fax | 623-434-3676
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN D MUSIL
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Credential | PHARM.D.
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Telephone | 623-434-3650
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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 | W001701
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License Number State | AZ
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