Organization
COMMUNITY DRUGSTORE III LLC
Active
Other names
Community Pharmacy III
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA GUBERNICK (ADMINISTRATOR)
(480) 281-1406
Entity
Organization
Contact information
Practice address
2222 E HIGHLAND AVE, PHOENIX, AZ 85016-4872
(602) 682-7660
(602) 682-7753
Mailing address
7701 E GRAY RD, SUITE 107, SCOTTSDALE, AZ 85260-6958
(602) 468-6337
(480) 212-4933
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005063
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0355734
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
387842
—
AZ
Enumeration date
11/18/2008
Last updated
03/02/2010
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