Organization
FRYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYLE GREEN TRONE PHARMD (PHARMACIST)
(520) 458-0997
Entity
Organization
Contact information
Practice address
500 S 99TH AVE, TOLLESON, AZ 85353-9700
(520) 458-0997
(520) 458-5849
Mailing address
500 S 99TH AVE, TOLLESON, AZ 85353-9700
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
S020208
AZ
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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