Organization
ASANTE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEO BLAISE RUKUNDO PHARMD, MBA (MANAGING DIRECTOR)
(857) 247-8763
Entity
Organization
Contact information
Practice address
16960 W BELL RD, SURPRISE, AZ 85374-8937
(602) 900-3506
Mailing address
16960 W BELL RD, SURPRISE, AZ 85374-8937
(857) 247-8763
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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