Organization
PALOVERDE HEALTH SERVICES PHARMACY LLC
Active
Other names
PaloVerde Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN EDWARD PAULL (OWNER/PIC)
(928) 485-4315
Entity
Organization
Contact information
Practice address
18 W CENTER ST, PIMA, AZ 85543-0030
(928) 322-6009
Mailing address
PO BOX 9, PIMA, AZ 85543-0009
(928) 485-4315
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097392
—
AZ
Enumeration date
01/25/2021
Last updated
02/09/2022
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