Organization
COMMUNITY DRUGSTORE II LLC
Active
Other names
COMMUNITY PHARMACY II
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA GUBERNICK (MANAGER)
(602) 468-6337
Entity
Organization
Contact information
Practice address
777 W SOUTHERN AVE, 415, MESA, AZ 85210-5008
(480) 464-5472
(480) 464-5485
Mailing address
7701 E GRAY RD, SUITE 107, SCOTTSDALE, AZ 85260-6958
(602) 468-6337
(480) 212-4933
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004893
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0355025
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
263561
—
AZ
Enumeration date
09/28/2007
Last updated
04/23/2010
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