Organization
COMMUNITY DRUG STORE, LLC
Active
Other names
Community Pharmacy IV
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY GUBERNICK RPH (OWNER)
(480) 575-1103
Entity
Organization
Contact information
Practice address
3050 N WINDSONG DR, SUITE 103, PRESCOTT VALLEY, AZ 86314-2265
(480) 575-1103
Mailing address
7305 E VISAO DR, SCOTTSDALE, AZ 85266-2707
(480) 575-1103
(602) 298-6934
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005106
AZ
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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