Organization · NPI-2

Arizona Community Pharmacy

Pharmacy, Long Term Care Pharmacy · Peoria, AZ

NPI number1467958611
StatusActive
Last updated in NPPESJan 14, 2019

Details

NPI
1467958611
Entity type
Organization (NPI-2)
Legal business name
Arizona Community Pharmacy
Organization subpart
No
Enumeration date
Apr 4, 2018
Last updated
Jan 14, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336L0003X Pharmacy, Long Term Care Pharmacy–AZYes
333600000X PharmacyY007643AZ
3336C0003X Pharmacy, Community/Retail Pharmacy–AZ

Practice location

14100 N 83rd Ave Ste 160
Peoria, AZ 85381

Phone 623-230-3194 · Fax 623-233-1610

Mailing address

14100 N 83rd Ave Ste 160
Peoria, AZ 85381-5653

Phone 623-230-3194 · Fax 623-233-1610

Authorized official

Yuliya K Ilyushenko
Owner
3237045369

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