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General NPI Number Information
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NPI Number | 1497099089
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Entity Type | Organization
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Legal Business Name | PHARMCAREUSA OF PHOENIX, LLC
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 4320 E BROWN RD STE 106
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City | MESA
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State | AZ
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Zip | 85205-4081
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Country | US
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Telephone | 480-832-9008
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Fax | 480-832-9008
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Provider Business Mailing Address
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Address Line | 4320 E BROWN RD SUITE 106
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City | MESA
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State | AZ
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Zip | 85205-4082
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Country | US
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Telephone | 480-832-9008
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Fax | 480-832-9008
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Authorized Official
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Title or Position | MANAGER
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Name | BARNEY ABBOTT
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Credential |
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Telephone | 866-403-2003
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | Y005559
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License Number State | AZ
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