Organization
HSP INC
Active
Other names
Ranch pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED ESLAM ELMISSIREY (PIC)
(480) 444-6612
Entity
Organization
Contact information
Practice address
3415 W GLENDALE AVE STE 27A, PHOENIX, AZ 85051-8391
(480) 888-8128
(480) 888-8128
Mailing address
3415 W GLENDALE AVE STE 27A, PHOENIX, AZ 85051-8391
(480) 888-8128
(480) 888-8128
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140027
PK
—
Enumeration date
04/24/2013
Last updated
04/24/2013
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