HAVASU HEALTH CARE PHARM (NPI# 1255591418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255591418 |
| Entity Type | Organization |
| Organization Name | HAVASU HEALTH CARE PHARM |
| Other Organization Name | HAVASU HEALTH CARE PHARM |
| Practice Address |
3560 Challenger Dr Ste 106 Lake Havasu City AZ 86406-9152 |
| Practice Telephone | 9288559888 |
| Practice Fax Number | 9288559888 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |
| Authorized Official Name | KELLY DAHLBERG (OWNER) |
| Authorized Official Telephone | 9288559888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Y0004984 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 0355366 | 01 |
| Other Name | Type Code |
|---|---|
| HAVASU HEALTH CARE PHARM | Doing Business As Name - Organization |
| Street Address |
3560 CHALLENGER DR STE 106 |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86406-9152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924070 | James Richard Fisher | Durable Medical Equipment & Medical Supplies | 2540 Viejo Dr, Lake Havasu City, AZ 86406 | 2008-02-27 |
| 1265657969 | Eugene Vitvitsky Md | Surgery | 2046 Burke Lane, Lake Havasu City, AZ 86406 | 2007-04-16 |
| 1659497105 | Assisted Living Concepts Inc | Assisted Living Facility | 3076 Shoshone Drive, Lake Havasu, AZ 86406 | 2007-03-22 |
| 1164546750 | Charles Reese Mead | Dentist | 101 Riveria Dr, Lake Havasu, AZ 86406 | 2007-03-19 |
| 1427172550 | Jesdeen Lynn Nunez | Registered Nurse | 12033 Agency Road, Parker, AZ 86406 | 2007-03-16 |
| 1285797993 | Karen Ann Powell | Podiatrist | Oro Grande Elementary 1250 Pawnee Drive, Lake Havasu City, AZ 86406 | 2006-12-18 |
| 1215978606 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2800 Sweetwater Ave, Lake Havasu City, AZ 86406 | 2006-06-09 |
| 1467519512 | Catherine Evelyn Sondrol | Occupational Therapist | 3588 Tarpon Dr, Lake Havasu City, AZ 86406-4223 | 2007-01-01 |
| 1346477593 | Steven Bertovich | Registered Nurse | 3499 Tarpon Dr, Lake Havasu City, AZ 86406-4246 | 2009-06-15 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| Find all providers in zip 86406 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749860 | Adepa Pharmacy Pllc | Pharmacy | 8770 N Thornydale Rd, Tucson, AZ 85742-9096 | 2020-10-26 |
| 1801493705 | Cd Pharmacy LLC | Pharmacy | 2710 S Roosevelt St, Tempe, AZ 85282-2089 | 2020-10-04 |
| 1326695545 | Lifecare Pharmacy Yuma LLC | Pharmacy | 2514 South Ave A, Suite 2, Yuma, AZ 85365 | 2019-08-22 |
| 1912366774 | Pharmcare Usa of Greater Phoenix LLC | Pharmacy | 1835 S Alvernon Way Ste 202, Tucson, AZ 85711-5693 | 2016-02-22 |
| 1710388384 | Pharmacy Care Provider LLC | Pharmacy | 1135 N Jefferson Ave, Tucson, AZ 85712-5009 | 2014-09-15 |
| 1912312315 | East Valley Patient Care Services | Pharmacy | 218 W Hampton Ave, #4, Mesa, AZ 85210-5231 | 2014-06-24 |
| 1235565581 | Guardian Pharmacy of Tucson LLC | Pharmacy | 10900 N Stallard Pl, Oro Valley, AZ 85737-9544 | 2013-09-18 |
| 1972944221 | Genoa Healthcare, LLC | Pharmacy | 1500 S White Mountain Rd, Bldg 3, Suite 302, Show Low, AZ 85901-7929 | 2013-07-16 |
| 1730422601 | Genoa Healthcare, LLC | Pharmacy | 10240 N 31st Ave Ste 210, Phoenix, AZ 85051-9565 | 2013-03-29 |
| 1093067670 | Genoa Healthcare, LLC | Pharmacy | 15317 W Bell Rd Ste 106, Suite 106, Surprise, AZ 85374-3901 | 2012-10-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86406 |
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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.