Organization
MG PHARMACY
Active
Other names
MG PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MORRIS GORTLER (OWNER)
(602) 439-3366
Entity
Organization
Contact information
Practice address
4025 W BELL RD, STE 1A, PHOENIX, AZ 85053-2750
(602) 439-3366
Mailing address
4025 W BELL RD, STE 1A, PHOENIX, AZ 85053-2750
(602) 439-3366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
001768
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0314396
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
078958
—
AZ
Enumeration date
08/10/2006
Last updated
01/10/2012
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