MEDICARE: SALIBUS UNITED DRUG 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
1	333600000X	Pharmacy	Y01642	AZ

General Provider Information

NPI Number	:	1215918107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALIBUS UNITED DRUG PHARMACY

Provider Business Mailing Address
First Line	:	PO BOX 68
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-0068
Country	:	US
Telephone Number	:	623-583-9431
Fax Number	:	623-583-2044

Provider Business Practice Location Address
First Line	:	11713 W THUNDERBIRD RD
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335
Country	:	US
Telephone Number	:	623-583-9431
Fax Number	:	623-583-2044

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN D SALIBA
Credential	:
Telephone Number	:	602-818-3085

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/22/2020

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