Organization
CASA GRANDE PHARMACY INC
Active
Organization
CASA GRANDE PHARMACY INC
Active
Other names
Grand Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED ESLAM ELMISSIREY RPH (OFFICER,PIC,AO)
(480) 444-6612
Entity
Organization
Contact information
Practice address
1659 E FLORENCE BLVD STE 7, CASA GRANDE, AZ 85122-4785
(520) 518-5720
(480) 371-2757
Mailing address
1659 E FLORENCE BLVD STE 7, CASA GRANDE, AZ 85122-4785
(520) 518-5720
(480) 371-2757
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006618
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083433
—
AZ
01
—
2155127
PK
—
Enumeration date
11/10/2015
Last updated
02/11/2016
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