Organization
HEALTHCARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON GRESHAM (PRESIDENT)
(602) 704-0044
Entity
Organization
Contact information
Practice address
2320 W PEORIA AVE STE D132-A, PHOENIX, AZ 85029-4753
(602) 704-0044
(602) 767-5522
Mailing address
2320 W PEORIA AVE STE D132-A, PHOENIX, AZ 85029-4753
(602) 704-0044
(602) 767-5522
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155435
—
AZ
Enumeration date
04/20/2023
Last updated
04/20/2023
Update your record
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