# WICKENBURG HOSPITAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417359753
- **Authorized official:** MR. ROGER ROSE PHARMD (PHARMACY DIRECTOR)
- **Authorized official phone:** (928) 684-4980

## Contact information

- **Practice address:** 520 ROSE LN, WICKENBURG, AZ 85390-1447
- **Practice address phone:** (928) 684-4980
- **Mailing address:** 21106 N GOLD POPPY LN, SURPRISE, AZ 85387-2743
- **Mailing address phone:** (623) 547-5987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | BW8158570 | AZ | Yes |

## Other

- **Enumeration date:** 09/18/2014
- **Last updated:** 09/18/2014