Organization
TAILSTORM HEALTH LLC
Active
Other names
Valley of the Sun Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HARTLEY MILLER (OFFICER)
(602) 896-0454
Entity
Organization
Contact information
Practice address
15600 N BLACK CANYON HWY, STE B135, PHOENIX, AZ 85053-4055
(602) 896-0454
(602) 896-0456
Mailing address
15600 N BLACK CANYON HWY, STE B135, PHOENIX, AZ 85053-4055
(602) 896-0454
(602) 896-0456
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006311
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151503
PK
—
05
—
410717
—
AZ
Enumeration date
08/30/2006
Last updated
07/21/2016
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