Organization
SIERRA PHARMACY LLC
Active
Other names
Sierra Pharmacy & Compounding Lab
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY ROETHER PHARMD (MANAGER)
(520) 459-0705
Entity
Organization
Contact information
Practice address
2085 E FRY BLVD, SIERRA VISTA, AZ 85635-2708
(520) 459-0705
(520) 459-1527
Mailing address
2085 E FRY BLVD, SIERRA VISTA, AZ 85635-2708
(520) 459-0705
(520) 459-1527
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005507
AZ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118393
PK
—
05
—
413129
—
AZ
Enumeration date
11/20/2008
Last updated
08/10/2016
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