Organization
HOLISTIC HEALTHCARE LLC
Active
Organization
HOLISTIC HEALTHCARE LLC
Active
Other names
Greenway Tantra Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
BABATUNDE GHANNI PHARM D (MANAGER, PIC)
(602) 993-0766
Entity
Organization
Contact information
Practice address
3361 W GREENWAY RD, STE.2, PHOENIX, AZ 85053-7641
(602) 993-0766
(602) 993-0768
Mailing address
3361 W GREENWAY RD, STE.2, PHOENIX, AZ 85053-7641
(602) 993-0766
(602) 993-0768
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005773
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142772
PK
—
05
—
887356
—
AZ
Enumeration date
10/18/2013
Last updated
04/06/2017
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