Organization
RALEY'S ARIZONA LLC
Active
Other names
BASHAS, Bashas' United Drug 102
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCKINLEY (DIRECTOR OF PHARMACY)
(480) 895-5372
Entity
Organization
Contact information
Practice address
20351 N LAKE PLEASANT RD, PEORIA, AZ 85382-9703
(623) 537-2321
(623) 537-2323
Mailing address
20351 N LAKE PLEASANT RD, PEORIA, AZ 85382-9703
(623) 537-2321
(623) 537-2323
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Y003677
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327622
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
774449
—
AZ
Enumeration date
08/20/2006
Last updated
04/18/2022
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