Organization
HSP INC
Active
Other names
prescott valley pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED ELMISSIREY (CFO)
(480) 444-6612
Entity
Organization
Contact information
Practice address
3050 N WINDSONG DR, STE 103, PRESCOTT VALLEY, AZ 86314-2265
(928) 350-1500
(928) 350-1504
Mailing address
3050 N WINDSONG DR, STE 103, PRESCOTT VALLEY, AZ 86314-2265
(928) 350-1500
(928) 350-1504
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005364
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0357031
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/04/2011
Last updated
04/26/2011
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