Organization
PARADISE VALLEY COMPOUNDING PHARMACY LLC
Active
Other names
Paradise Valley Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PATTIYA WATTANANIMITGUL (PIC)
(623) 200-3000
Entity
Organization
Contact information
Practice address
5410 N SCOTTSDALE RD STE A400, PARADISE VALLEY, AZ 85253-5963
(623) 200-3000
Mailing address
5410 N SCOTTSDALE RD STE A400, PARADISE VALLEY, AZ 85253-5963
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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