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General NPI Number Information
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NPI Number | 1689163925
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Entity Type | Organization
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Legal Business Name | PHARMAPRODIA LLC
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 15331 W BELL RD STE 122
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City | SURPRISE
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State | AZ
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Zip | 85374-4103
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Country | US
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Telephone | 623-404-1000
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Fax | 623-256-6491
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Provider Business Mailing Address
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Address Line | 15331 W BELL RD SUITE 122
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City | SURPRISE
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State | AZ
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Zip | 85374-4102
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Country | US
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Telephone | 623-404-1000
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Fax | 623-256-6491
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Authorized Official
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Title or Position | FOUNDER
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Name | RICHARD NKWENTI
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Credential |
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Telephone | 623-432-5500
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | Y007343
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License Number State | AZ
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