Organization
RALEY'S ARIZONA LLC
Active
Other names
BASHAS, Bashas' United Drug 130
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
5115 N DYSART RD, LITCHFIELD PARK, AZ 85340-3032
(623) 547-4581
(623) 547-4583
Mailing address
5115 N DYSART RD, LITCHFIELD PARK, AZ 85340-3032
(623) 547-4581
(623) 547-4583
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y003851
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327925
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
821464
—
AZ
Enumeration date
08/20/2006
Last updated
04/18/2022
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