Organization
SANTA TERESA PHARMACY LLC
Active
Organization
SANTA TERESA PHARMACY LLC
Active
Other names
Santa Teresa Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ SHAH (MEMBER)
(928) 328-1000
Entity
Organization
Contact information
Practice address
151 S OAK AVE STE 200, SAN LUIS, AZ 85336-0756
(928) 328-1000
(928) 328-1001
Mailing address
151 S OAK AVE STE 200, SAN LUIS, AZ 85336-0756
(928) 328-1000
(928) 328-1001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0356786
NCPDP
—
01
—
2125859
PK
—
Enumeration date
07/22/2010
Last updated
11/16/2021
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