Organization
AVELLA OF GRAYHAWK, 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
7336 E DEER VALLEY RD, STE 100, SCOTTSDALE, AZ 85255-7455
(480) 538-0699
(480) 538-0795
Mailing address
1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
(623) 434-1700
(623) 434-3673
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005092
AZ
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0324967
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
557952
—
AZ
Enumeration date
06/17/2005
Last updated
04/30/2013
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