Organization
UPTOWN PHARMACY OF KINGMAN , INC
Active
Organization
UPTOWN PHARMACY OF KINGMAN , INC
Active
Other names
UPTOWN DRUG GOLDEN VALLEY
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS HOWARD PROFFIT B.S. PHARMACY (OWNER)
(928) 565-3900
Entity
Organization
Contact information
Practice address
4263 US HIGHWAY 68, STE B, GOLDEN VALLEY, AZ 86413-8569
(928) 565-3900
(928) 565-4004
Mailing address
4263 US HIGHWAY 68, STE B, GOLDEN VALLEY, AZ 86413-8569
(928) 565-3900
(928) 565-4004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y007048
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1990529
PK
—
05
—
235609
—
AZ
Enumeration date
08/10/2006
Last updated
04/11/2024
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