Organization
DESERT SKY PHARMACY, LLC
Active
Other names
Desert Sky Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAI PHAM PHARMACIST (OWNER-PHARMACIST IN CHARGE)
(623) 209-0870
Entity
Organization
Contact information
Practice address
6750 W THUNDERBIRD RD STE 103, PEORIA, AZ 85381-5046
(623) 209-0870
(623) 209-0872
Mailing address
6750 W THUNDERBIRD RD STE 103, PEORIA, AZ 85381-5046
(623) 209-0870
(623) 209-0872
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005103
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118934
PK
—
05
—
408470
—
AZ
Enumeration date
02/03/2009
Last updated
04/05/2017
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