Organization
MEDCO AT HOME LLC
Active
Other names
MEDCO HEALTH SOLUTIONS OF SCOTTSDALE
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CANNONE (SENIORDIRECTOR, LICENSING)
(314) 684-5075
Entity
Organization
Contact information
Practice address
14811 N KIERLAND BLVD, STE 100 RM 109, SCOTTSDALE, AZ 85254-2729
(480) 368-5005
(480) 368-5040
Mailing address
14811 N KIERLAND BLVD, STE 100 RM 109, SCOTTSDALE, AZ 85254-2729
(480) 368-5005
(480) 368-5040
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
Y004924
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0355304
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/03/2008
Last updated
01/28/2013
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