Organization · NPI-2

Avella Of Chandler, INC

Pharmacy, Community/Retail Pharmacy · Tempe, AZ

NPI number1720083462
StatusActive
Last updated in NPPESApr 30, 2013

Details

NPI
1720083462
Entity type
Organization (NPI-2)
Legal business name
Avella Of Chandler, INC
Organization subpart
Yes
Enumeration date
Jun 17, 2005
Last updated
Apr 30, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyY005093AZYes
3336C0004X Pharmacy, Compounding PharmacyY005093AZ
3336S0011X Pharmacy, Specialty PharmacyY005093AZ

Practice location

2155 E Conference Dr
Ste 101
Tempe, AZ 85284-2604

Phone 480-775-4784 · Fax 480-730-9734

Mailing address

1606 W Whispering Wind Dr
Phoenix, AZ 85085-0678

Phone 623-434-1700 · Fax 623-434-3673

Authorized official

John D Musil
Ceo
6234343657

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