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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