Organization
AVELLA OF PHOENIX II, INC.
Active
Organization
AVELLA OF PHOENIX II, INC.
Active
Parent organization
APOTHECARY HOLDINGS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
APOTHECARY HOLDINGS, INC.
Authorized official
JOHN D MUSIL (CEO)
(623) 434-3657
Entity
Organization
Contact information
Practice address
5040 N 15TH AVE STE 102, PHOENIX, AZ 85015-3329
(602) 277-3181
(602) 277-3418
Mailing address
1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
(623) 434-1700
(623) 434-3676
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005091
AZ
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0326466
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
630469
—
AZ
Enumeration date
06/17/2005
Last updated
09/11/2012
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