Organization
AVELLA OF GRAYHAWK, INC.
Active
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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