NORTHERN ARIZONA PHARMACY LLC (NPI# 1194175588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194175588 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA PHARMACY LLC |
| Other Organization Name | CHINO VALLEY PHARMACY |
| Practice Address |
1932 N State Route 89 Chino Valley AZ 86323-5643 |
| Practice Telephone | 9285150046 |
| Practice Fax Number | 9285150047 |
| Mailing Telephone | 9285150046 |
| Mailing Fax Number | 9285150047 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | DR. JASON JAMES DYKSTRA (PHARMACIST) |
| Authorized Official Telephone | 9285150046 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Y006900 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 171606 | 05 | |
| PK | 2160678 | 01 |
| Other Name | Type Code |
|---|---|
| Chino Valley Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445802 | Northern Arizona Pharmacy LLC | Pharmacy | 12075 E State Route 69, Suite E, Dewey, AZ 86327 | 2019-12-26 |
| Street Address |
1932 N STATE ROUTE 89 |
| City | CHINO VALLEY |
| State | AZ |
| Zip Code | 86323-5643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801126024 | Jason James Dykstra | Pharmacist | 1932 N State Route 89, Chino Valley, AZ 86323-5643 | 2010-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013558816 | Enbrace Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 743 East Road 2 N, Chino Valley, AZ 86323 | 2019-10-02 |
| 1164943197 | Kevin Ross Pullins | Spec/Tech, Cardiovascular | 605 Park Pl, Chino Valley, AZ 86323 | 2017-06-29 |
| 1255700779 | Deanna Hartsough | Chiropractor | 1352 Taft Ave, Chino Valley, AZ 86323 | 2015-09-15 |
| 1366824369 | Advanced Chiropractic Health Centre, LLC | Chiropractor | 2235 S Hwy 89 Ste B7, Chino Valley, AZ 86323 | 2015-06-25 |
| 1417360835 | Hospice Family Care, Inc. | Hospice Care, Community Based | 448 N Hwy 89, Suite G & H, Chino Valley, AZ 86323 | 2014-06-03 |
| 1053744268 | Sonora Quest Laboratories, LLC | Clinical Medical Laboratory | 1031 Az-89, Chino Valley, AZ 86323 | 2013-08-12 |
| 1891031696 | Jody Hoitt | Registered Nurse | 3455 W. Oak Creek Lane, Chino Valley, AZ 86323 | 2012-12-26 |
| 1508113275 | Augustine Fella Aworuwa | Pharmacist | 1020 State Route 89 North, Chino Valley, AZ 86323 | 2012-08-13 |
| 1104090737 | John R. Markham PC | Eyewear Supplier (Equipment, not the service) | 399 Palomino Road, Chino Valley, AZ 86323 | 2008-04-15 |
| 1962690289 | Nancy Louise Ethridge | Speech-Language Pathologist | 650 E. Center St, Chino Valley, AZ 86323 | 2007-10-11 |
| Find all providers in zip 86323 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244861 | Canyonlands Community Healthcare | Pharmacy | 103 Fairgrounds Rd, Duncan, AZ 85534-8234 | 2020-10-26 |
| 1790384212 | Copilot Provider Support Services | Pharmacy | 8700 East Pinnacle Peak Road Ste 111, Johnson Bank Building, Scottsdale, AZ 85255-8525 | 2020-10-26 |
| 1366041501 | White Nile | Pharmacy | 4338 W Thomas Rd Unit E5, Phoenix, AZ 85031-3878 | 2020-10-20 |
| 1366050536 | Mariposa Community Health Center | Pharmacy | 1103 Circulo Mercado, Rio Rico, AZ 85648-6248 | 2020-07-14 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1952924847 | Cheryl Mackie | Pharmacy | 8010 E Mcdowell Rd Ste 201-206, Scottsdale, AZ 85257-3867 | 2020-05-26 |
| 1306472865 | Cordant Pharmacy Arizona, LLC | Pharmacy | 6641 E Baywood Ave Ste 101, Mesa, AZ 85206-1723 | 2020-03-17 |
| 1215575824 | Maricopa County Special Health Care District | Pharmacy | 8088 W Whitney Dr, Peoria, AZ 85345 | 2019-12-13 |
| 1811532609 | Nexus Patient Services | Pharmacy | 5080 N 40th St Ste 300, Phoenix, AZ 85018-2164 | 2019-11-15 |
| 1649813320 | Hi-health-rx LLC | Pharmacy | 15207 N 75th St Ste 105, Scottsdale, AZ 85260-2445 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
| City | CHINO VALLEY |
| Zip Code | 86323 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.