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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