Organization
APOTHECARY SHOP OF PHOENIX, INC
Active
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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