Organization
SHREE JI CORPORATION
Active
Other names
Stapley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HITESH THAKAR (OWNER/PRESIDENT)
(480) 404-9160
Entity
Organization
Contact information
Practice address
1245 E SOUTHERN AVE STE 21, MESA, AZ 85204-5156
(480) 404-9160
(480) 758-5208
Mailing address
1245 E SOUTHERN AVE STE 21, MESA, AZ 85204-5156
(480) 404-9160
(480) 758-5208
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006743
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108706
—
AZ
01
—
2157610
PK
—
Enumeration date
01/21/2016
Last updated
04/11/2016
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