Organization · NPI-2

Ezyfast Pharmacy L L C

Pharmacy, Community/Retail Pharmacy · Bullhead City, AZ

NPI number1366717860
StatusActive
Last updated in NPPESMay 22, 2012

Details

NPI
1366717860
Entity type
Organization (NPI-2)
Legal business name
Ezyfast Pharmacy L L C
Organization subpart
No
Enumeration date
Mar 15, 2012
Last updated
May 22, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyY005478AZYes
3336C0004X Pharmacy, Compounding Pharmacy––
333600000X Pharmacy––

Other names

  • Ezyfast Pharmacy L.L.C (Doing Business As)

Practice location

2580 Highway 95 Ste 106
Bullhead City, AZ 86442-7324

Phone 928-219-5912 · Fax 928-219-5915

Mailing address

Po Box 21238
Bullhead City, AZ 86439-1238

Phone 928-219-5912 · Fax 928-219-5915

Authorized official

Ezekiel Kesitilwe
Owner
9282309812

Is something wrong?

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