Organization
AVONDALE NEIGHBORHOOD PHARMACY LLC
Active
Organization
AVONDALE NEIGHBORHOOD PHARMACY LLC
Active
Other names
AVONDALE NEIGHBORHOOD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAMECK NYAKWEBA RPH (OWNER)
(602) 430-9646
Entity
Organization
Contact information
Practice address
10750 W MCDOWELL RD, BLDG. A STE. 110, AVONDALE, AZ 85392-5960
(623) 932-9800
(623) 932-9817
Mailing address
10750 W MCDOWELL RD, BLDG. A STE. 110, AVONDALE, AZ 85392-5960
(623) 932-9800
(623) 932-9817
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004448
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0353398
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
113658
—
AZ
Enumeration date
05/11/2006
Last updated
11/01/2010
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