Organization
RALEY'S ARIZONA LLC
Active
Other names
BASHAS UNITED DRUG, Bashas United Drug 116
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
3269 MARICOPA AVE, STE 120, LAKE HAVASU CITY, AZ 86406-8593
(928) 854-9551
(928) 854-9553
Mailing address
PO BOX 488, DEPT 3, CHANDLER, AZ 85244-0488
(480) 895-9350
(480) 895-5371
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y003678
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327432
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
739063
—
AZ
Enumeration date
08/20/2006
Last updated
04/29/2022
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