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NPI Code Detail

MEDICARE: HEALTHCARE PHARMACY LLC

MEDICARE: HEALTHCARE PHARMACY LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336M0002XMail Order Pharmacy
33336S0011XSpecialty Pharmacy
43336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1861165920
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE PHARMACY LLC
Provider Business Mailing Address
First Line : 2320 W PEORIA AVE STE D132-A
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4753
Country : US
Telephone Number : 602-704-0044
Fax Number : 602-767-5522
Provider Business Practice Location Address
First Line : 2320 W PEORIA AVE STE D132-A
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4753
Country : US
Telephone Number : 602-704-0044
Fax Number : 602-767-5522
Authorized Official
Title or Position : PRESIDENT
Name : RON GRESHAM
Credential :
Telephone Number : 602-704-0044
Provider Enumeration Date : 07/26/2021
Last Update Date : 04/07/2023

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Directions to “HEALTHCARE PHARMACY LLC ” Practice Location

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