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General NPI Number Information
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NPI Number | 1801493705
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Entity Type | Organization
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Legal Business Name | CD PHARMACY LLC
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Dates
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Enumeration Date | 10/04/2020
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Last Update Date | 10/04/2020
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Provider Practice Location Address
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Address Line | 2710 S ROOSEVELT ST
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City | TEMPE
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State | AZ
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Zip | 85282-2089
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Country | US
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Telephone | 480-590-6886
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Fax | 480-590-6886
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Provider Business Mailing Address
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Address Line | 450 S 900 E STE 100
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City | SLC
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State | UT
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Zip | 84102-2983
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Country | US
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Telephone | 801-712-7522
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | KENNETH EDDIE NORRIS
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Credential |
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Telephone | 801-712-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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