Havasu Health Care Pharm

LBN: Havasu Health Care Pharm
Havasu Health Care Pharm is an health care organization with primary practice located at 3560 Challenger Dr Ste 106, Lake Havasu City AZ 86406-9152. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Long Term Care Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Havasu Health Care Pharm can be contacted via phone (928) 855-9888, or through Dahlberg, Kelly via phone (928) 855-9888.

Contact Information

Primary practice address
3560 Challenger Dr Ste 106 Lake Havasu City AZ 86406-9152
Phone: (928) 855-9888
Fax: (928) 855-9888
Website:
Map and Directions
Authorized official contact:
Name: Dahlberg, Kelly
Phone: (928) 855-9888

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X Y0004984 Arizona
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1255591418
LBN Legal business name Havasu Health Care Pharm
DBA Doing business as Havasu Health Care Pharm
Authorized official Dahlberg, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2008
Last updated Jun 11th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255591418 NPPES
Other 0355366 OTHER ID NUMBER

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