Organization
SCOTTSDALE PROFESSIONAL PHARMACY LTD
Active
Other names
SCOTTSDALE PROFESSIONAL PHARMACY, Customedico Pharmacy & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH KATHRYN SIMMERS PHARMD (PRESIDENT)
(480) 946-9477
Entity
Organization
Contact information
Practice address
10900 N SCOTTSDALE RD, SUITE 403, SCOTTSDALE, AZ 85254-5216
(480) 946-9477
(480) 946-1345
Mailing address
10900 N SCOTTSDALE RD STE 403, 10900 N SCOTTSDALE RD STE 403, SCOTTSDALE, AZ 85254-5218
(480) 946-9477
(480) 946-1345
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y001231
AZ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031584
—
AZ
01
—
1997302
PK
—
Enumeration date
09/20/2006
Last updated
07/29/2022
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