Organization
SUN VALLEY PHARMACY LLC
Active
Organization
SUN VALLEY PHARMACY LLC
Active
Other names
Sun Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HALIM HASSANI RPH (MEMBER)
(928) 927-5300
Entity
Organization
Contact information
Practice address
219 W PIMA, GILA BEND, AZ 85353
(928) 927-5300
(928) 927-5299
Mailing address
PO BOX 4620, QUARTZSITE, AZ 85359-4620
(480) 294-3391
(928) 927-5299
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005169
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0356293
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
470280
—
AZ
Enumeration date
08/14/2009
Last updated
11/15/2010
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