Organization
PHARMAPRODIA LLC
Active
Other names
Pharmaprodia Compounding Pharmacy Group
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD NKWENTI (FOUNDER)
(623) 432-5500
Entity
Organization
Contact information
Practice address
15331 W BELL RD STE 122, SURPRISE, AZ 85374-4103
(623) 404-1000
(623) 256-6491
Mailing address
15331 W BELL RD, SUITE 122, SURPRISE, AZ 85374-4102
(623) 404-1000
(623) 256-6491
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
Y007343
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177335
PK
—
Enumeration date
05/02/2018
Last updated
05/04/2018
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