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General NPI Number Information
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NPI Number | 1912499500
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Entity Type | Organization
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Legal Business Name | AZ PHARMACY, LLC
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 3809 E WATKINS ST
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City | PHOENIX
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State | AZ
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Zip | 85034-7264
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Country | US
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Telephone | 855-745-5725
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Fax | 623-289-9864
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Provider Business Mailing Address
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Address Line | 220 INDUSTRIAL BLVD STE 100
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City | AUSTIN
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State | TX
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Zip | 78745-1276
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Country | US
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Telephone | 855-745-5725
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Fax | 603-935-9108
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TANVI JAYANTI PATEL
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Credential |
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Telephone | 855-745-5725
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y007632
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License Number State | AZ
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