Organization
COMMUNITY DRUGSTORE III LLC
Active
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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