Organization
FAVOUR ENTERPRISES L.L.C
Active
Other names
Mercy rexall drugs
Organization subpart
No
Provider details
NPI number
Authorized official
OLUFEMI OMODARA (RPH)
(602) 230-2443
Entity
Organization
Contact information
Practice address
3330 N 2ND ST, PHOENIX, AZ 85012-2368
(602) 230-2443
(602) 274-7739
Mailing address
PO BOX 5693, GOODYEAR, AZ 85338-0612
(602) 230-2443
(602) 274-7739
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
Y005425
AZ
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0357295
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/14/2011
Last updated
10/14/2011
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