Organization
MAYO CLINIC ARIZONA
Active
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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