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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