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General NPI Number Information
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NPI Number | 1982152732
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Entity Type | Organization
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Legal Business Name | FREEDOM PHARMACY OF ARIZONA AT RED MOUNTAIN LLC
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 8035 E BROWN RD BLDG 4, STE C
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City | MESA
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State | AZ
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Zip | 85207-3901
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Country | US
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Telephone | 480-565-7222
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Fax | 480-499-0396
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Provider Business Mailing Address
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Address Line | 8035 E BROWN RD BLDG 4, STE C
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City | MESA
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State | AZ
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Zip | 85207
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Country | US
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Telephone | 480-565-7222
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Fax | 480-499-0396
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRIS SHALER
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Credential |
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Telephone | 480-993-9646
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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 | Y006920
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License Number State | AZ
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