Organization
RALEY'S ARIZONA LLC
Active
Other names
Bashas' United Drug 110
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
1133 N. ELLSWORTH, MESA, AZ 85207
(480) 984-3431
(480) 984-3689
Mailing address
1133 N ELLSWORTH RD, MESA, AZ 85207-5140
(480) 984-3431
(480) 984-3689
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Y007130
AZ
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y007130
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991871
PK
—
05
—
880684
—
AZ
Enumeration date
08/20/2006
Last updated
04/18/2022
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