Komatke Pharmacy
LBN: Gila River Health Care Corporation
Komatke Pharmacy is an health care organization with primary practice located at 17487 S Healthcare Dr , Laveen AZ 85339-8500. 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 / Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty.
Gila River Health Care Corporation can be contacted via phone (520) 550-6022, or through Croll, Larry via phone (602) 528-1200.
Contact Information
Primary practice address
17487 S Healthcare Dr
Laveen AZ 85339-8500
Phone: (520) 550-6022
Fax: (520) 550-6028
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | ||
Suppliers / Pharmacy | 333600000X |
Profile Details
NPI number | 1144359852 |
---|---|
LBN Legal business name | Gila River Health Care Corporation |
DBA Doing business as | Komatke Pharmacy |
Authorized official | Croll, Larry PHARMD |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Mar 6th, 2007 |
Last updated | Apr 28th, 2017 - about 7 years ago |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144359852 | NPPES |
Other | 1991256 | PK | |
MEDICAID | AHCCCS334582 | PK |
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