Organization
APOTHECARY SHOP OF PHOENIX, INC
Active
Other names
Apothecary Shop of Phoenix, INC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MUSIL (DIRECTOR/CEO)
(623) 434-3657
Entity
Organization
Contact information
Practice address
1701 E THOMAS RD STE 203, PHOENIX, AZ 85016-7674
(602) 252-6120
(602) 252-6127
Mailing address
1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
(623) 434-3659
(623) 434-3673
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005087
AZ
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0320212
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
474601
—
AZ
Enumeration date
10/21/2005
Last updated
02/07/2011
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