Organization
TAILSTORM HEALTH LLC
Active
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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