Organization
RALEY'S ARIZONA LLC
Active
Other names
BASHAS' UNITED DRUG, Bashas' United Drug 158
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
5555 N 7TH ST, PHOENIX, AZ 85014-2584
(602) 277-6133
(602) 277-6136
Mailing address
PO BOX 488, CHANDLER, AZ 85244-0488
(480) 895-5349
(480) 895-5214
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y004012
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0328383
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
854548
—
AZ
Enumeration date
10/10/2006
Last updated
04/13/2022
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