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NPI Code Detail

MEDICARE: EL RIO NORTHWEST PHARMACY

MEDICARE: EL RIO NORTHWEST PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0002XClinic Pharmacy

General Provider Information

NPI Number : 1093791873
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL RIO NORTHWEST PHARMACY
Provider Business Mailing Address
First Line : PO BOX 1231
Second Line :
City : TUCSON
State : AZ
Zip : 85702-1231
Country : US
Telephone Number : 520-670-3909
Fax Number : 520-838-7698
Provider Business Practice Location Address
First Line : 320 W PRINCE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-3526
Country : US
Telephone Number : 520-838-7660
Fax Number : 520-838-7698
Authorized Official
Title or Position : CEO
Name : CLINTON G KUNTZ
Credential :
Telephone Number : 520-601-0607
Provider Enumeration Date : 12/22/2005
Last Update Date : 04/23/2025

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Directions to “EL RIO NORTHWEST PHARMACY ” Practice Location

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