Organization
ANAZAOHEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS BERKOFF (VP, CFO)
(800) 995-4363
Entity
Organization
Contact information
Practice address
6630 W ARBY AVE, SUITE 102, LAS VEGAS, NV 89118-4682
(702) 873-8455
(702) 873-6845
Mailing address
5710 HOOVER BLVD, TAMPA, FL 33634-5339
(800) 995-4363
(800) 985-4363
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH01471
NV
3336C0004X
Compounding Pharmacy
PH01471
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH01471
PHARMACY LICENSE
NV
Enumeration date
05/16/2007
Last updated
09/07/2011
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