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Organization

MORTAR AND PESTLE

Active
Other names
Mortar & Pestle
Organization subpart
No

Provider details

NPI number
Authorized official
LAUREN DRIEBE (PHARMACIST IN CHARGE/OWNER)
(928) 526-2446
Entity
Organization

Contact information

Practice address
2708 N 4TH ST STE C-2, FLAGSTAFF, AZ 86004-1829
(928) 526-2446
(928) 526-2245
Mailing address
2708 N 4TH ST STE C-2, FLAGSTAFF, AZ 86004-1829
(928) 526-2446
(928) 526-2245

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
3336C0004X
Compounding Pharmacy
Primary
Y005140
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0356279
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
07/17/2009
Last updated
10/14/2010
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