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NPI Code Detail

MEDICARE: MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT

MEDICARE: MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
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
23336C0003XCommunity/Retail PharmacyY004189AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11997589OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194736769
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Provider Business Mailing Address
First Line : 33 W TAMARISK ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-2422
Country : US
Telephone Number : 602-344-6466
Fax Number : 602-344-6406
Provider Business Practice Location Address
First Line : 33 W TAMARISK ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-2422
Country : US
Telephone Number : 602-344-6466
Fax Number : 602-344-6406
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : ANNA SOGARD
Credential :
Telephone Number : 602-344-5253
Provider Enumeration Date : 08/10/2006
Last Update Date : 10/24/2019

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Directions to “MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT ” Practice Location

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