Organization
RALEY'S ARIZONA LLC
Active
Organization
RALEY'S ARIZONA LLC
Active
Other names
Bashas' United Drug 109, BASHAS
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
21044 N JOHN WAYNE PKWY, MARICOPA, AZ 85139-2916
(520) 836-4401
(520) 836-4403
Mailing address
21044 N JOHN WAYNE PKWY, MARICOPA, AZ 85139-2916
(520) 836-4401
(520) 836-4403
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y004018
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0328408
NCPDP
—
05
—
859986
—
AZ
Enumeration date
08/20/2006
Last updated
04/15/2022
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