Pimc Pharmacy

LBN: Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm
Pimc Pharmacy is an health care organization with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm can be contacted via phone (602) 263-1200, or through Tillman, Laura A via phone (602) 263-1567.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Phone: (602) 263-1200
Fax: (602) 263-1619
Website:
Map and Directions
Authorized official contact:
Name: Tillman, Laura A Doctor of Medicine (MD)
Phone: (602) 263-1567

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X AZS07912 Arizona
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1801900766
LBN Legal business name Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm
DBA Doing business as Pimc Pharmacy
Authorized official Tillman, Laura A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 18th, 2006
Last updated May 19th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801900766 NPPES
Other 0324602 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 022062 NCPDP PROVIDER IDENTIFICATION NUMBER

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