Chino Valley Pharmacy

LBN: Northern Arizona Pharmacy Llc
Chino Valley Pharmacy is an health care organization with primary practice located at 1932 N State Route 89 , Chino Valley AZ 86323-5643. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Northern Arizona Pharmacy Llc can be contacted via phone (928) 515-0046, or through Dykstra, Jason James via phone (928) 515-0046.

Contact Information

Primary practice address
1932 N State Route 89 Chino Valley AZ 86323-5643
Phone: (928) 515-0046
Fax: (928) 515-0047
Website:
Map and Directions
Authorized official contact:
Name: Dykstra, Jason James PHARMD
Phone: (928) 515-0046

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X Y006900 Arizona
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1194175588
LBN Legal business name Northern Arizona Pharmacy Llc
DBA Doing business as Chino Valley Pharmacy
Authorized official Dykstra, Jason James PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jun 15th, 2016
Last updated Dec 20th, 2019 - about 5 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 1194175588 NPPES
Arizona MEDICAID 171606
Arizona Other 2160678

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