Organization
MELROSE PHARMACY LLC
Active
Organization
MELROSE PHARMACY LLC
Active
Other names
MELROSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA STICKLER (PRESIDENT)
(602) 277-4714
Entity
Organization
Contact information
Practice address
706 W MONTECITO AVE, PHOENIX, AZ 85013-2814
(602) 277-4714
(602) 264-1469
Mailing address
706 W MONTECITO AVE, PHOENIX, AZ 85013-2814
(602) 277-4714
(602) 264-1469
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y04279
AZ
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991935
PK
—
05
—
980319
—
AZ
Enumeration date
08/20/2006
Last updated
02/20/2017
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