Organization
RALEY'S ARIZONA LLC
Active
Other names
FOOD CITY, Food City United Drug 094
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
3442 W VAN BUREN ST, PHOENIX, AZ 85009-4708
(602) 278-8831
(602) 484-0950
Mailing address
3442 W VAN BUREN ST, PHOENIX, AZ 85009-4708
(602) 278-8831
(602) 484-0950
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y003933
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0328472
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
864191
—
AZ
Enumeration date
10/10/2006
Last updated
04/18/2022
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