Organization
COMMUNITY PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GUBERNICK (OWNER)
(480) 575-1103
Entity
Organization
Contact information
Practice address
17233 N HOLMES BLVD, STE 1615, PHOENIX, AZ 85053-2018
(602) 993-2600
Mailing address
7305 E VISAO DR, SCOTTSDALE, AZ 85266-2707
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1918
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300664
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
303446
—
AZ
Enumeration date
08/10/2006
Last updated
03/18/2008
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