Organization
BIG PARK PHARMACY LLC
Active
Other names
sedona compounding pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG HUSER RPH (PHARMACIST)
(602) 740-0451
Entity
Organization
Contact information
Practice address
3150 W STATE ROUTE 89A STE 5, SEDONA, AZ 86336-4924
(928) 284-9593
(928) 284-9605
Mailing address
3150 W STATE ROUTE 89A STE 5, SEDONA, AZ 86336-4924
(928) 284-9593
(928) 284-9605
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
Y02989
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0323129
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/17/2007
Last updated
05/25/2011
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