Organization
RALEY'S ARIZONA LLC
Active
Other names
Bashas United Drug 120, BASHAS
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
7586 W THUNDERBIRD RD, PEORIA, AZ 85381-6077
(623) 334-2081
(623) 334-2083
Mailing address
7586 W THUNDERBIRD RD, PEORIA, AZ 85381-6077
(623) 334-2081
(623) 334-2083
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y003645
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327165
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
722597
—
AZ
Enumeration date
10/10/2006
Last updated
04/29/2022
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