Organization
MAYO CLINIC ARIZONA
Active
Other names
Mayo Clinic Building Phoenix Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSHANAK DIDEHBAN (CAO)
(480) 301-6493
Entity
Organization
Contact information
Practice address
5881 E MAYO BLVD, # STE 1-304, PHOENIX, AZ 85054-4505
(480) 342-4100
(480) 342-4180
Mailing address
PO BOX 083268, CHICAGO, IL 60691-0268
(507) 284-3390
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Y006569
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336I0012X
Institutional Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155895
PK
—
Enumeration date
12/15/2015
Last updated
08/11/2025
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