Organization
RALEY'S ARIZONA LLC
Active
Other names
Bashas', Food City, AJ's United Drugs, Food City United Drug 108
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
1831 KIOWA AVE STE 100, LAKE HAVASU CITY, AZ 86403-2461
(928) 855-2494
(928) 855-4794
Mailing address
PO BOX 488, CHANDLER, AZ 85244-0488
(480) 895-9350
(480) 895-5214
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
4311
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024626
—
AZ
01
—
0354275
NCPDP
AZ
Enumeration date
06/11/2006
Last updated
04/29/2022
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