STATE OF ARIZONA (NPI# 1578752762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578752762 |
| Entity Type | Organization |
| Organization Name | STATE OF ARIZONA |
| Other Organization Name | BLACK CANYON SCHOOL PHARMACY |
| Practice Address |
24601 N 29th Ave Phoenix AZ 85083-1165 |
| Practice Telephone | 6237801303 |
| Practice Fax Number | 6238797026 |
| Mailing Telephone | 6237801303 |
| Mailing Fax Number | 6238797026 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | RONALD WILLIAMS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6025201663 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
Y01936 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 1988966 | 01 |
| Other Name | Type Code |
|---|---|
| BLACK CANYON SCHOOL PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730295684 | State of Arizona | Pharmacy | 1295 N Martin, Tucson, AZ 85721-0001 | 2006-08-22 |
| 1538170162 | State of Arizona | Pharmacy | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2006-08-10 |
| 1396845343 | State of Arizona | Pharmacy | 1224 E Lowell St, Tucson, AZ 85721-0095 | 2006-09-22 |
| Street Address |
24601 N 29TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85083-1165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932686045 | David Cottrell | Counselor | 24601 N 29th Ave, Phoenix, AZ 85083-1165 | 2018-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275042657 | Prestige Group Homes | Assisted Living Facility | 28001 N 31st Ave, Phoenix, AZ 85083 | 2017-09-28 |
| 1467702068 | Chirag Javia | Pharmacist | 5029 W. Buckskin Trail, Phoenix, AZ 85083 | 2012-09-12 |
| 1568944049 | Nicholas Ryan Wieferich | Pharmacist | 5450 W Happy Valley Rd, Phoenix, AZ 85083 | 2018-08-31 |
| 1992258743 | Andrew Jon Cefalo | Dentist | 25155 N 67th Ave Ste 142, Phoenix, AZ 85083 | 2016-07-28 |
| 1538643242 | Nel's Nest Assisted Living, LLC | Assisted Living Facility | 3655 W Dynamite Blvd, Phoenix, AZ 85083-0860 | 2018-09-18 |
| 1508211673 | Mansi Dave | Internal Medicine | 5164 W Quail Track Dr, Phoenix, AZ 85083-0863 | 2016-04-26 |
| 1043797905 | Kara A Fishgold | Nurse Practitioner | 6325 W Briles Rd, Phoenix, AZ 85083-1003 | 2018-07-24 |
| 1053455634 | Melanie O'rourke Speech Services, LLC | Speech-Language Pathologist | 6350 W Lariat Ln, Phoenix, AZ 85083-1004 | 2007-02-16 |
| 1538437538 | Melanie O'rourke | Speech-Language Pathologist | 6350 W Lariat Ln, Phoenix, AZ 85083-1004 | 2011-12-05 |
| 1508280496 | Stephen Wayne Champion | Registered Nurse | 25830 N 64th Ave, Phoenix, AZ 85083-1014 | 2014-02-12 |
| Find all providers in zip 85083 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1710091780 | Los Ninos Hospital Inc | Pharmacy | 2303 E Thomas Rd, Phoenix, AZ 85016-7827 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568928521 | Winslow Indian Health Care Center, Inc | Pharmacy | 1.5 Mile N. Leupp Chapter House, Leupp, AZ 86047 | 2019-02-14 |
| 1659837615 | Winslow Indian Health Care Center, Inc | Pharmacy | 3 Mls S. of Dilkon Chapter Hse., Dilkon, AZ 86047 | 2019-02-14 |
| 1992084941 | Institutional Pharmacy Solutions | Pharmacy | 6350 S Maple Ave, Tempe, AZ 85283-2857 | 2011-08-09 |
| 1386832087 | Winslow Indian Health Care Center, Inc | Pharmacy | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2007-10-09 |
| 1306988209 | Page Hospital Pharmacy | Pharmacy | 501 N Navajo, Page, AZ 86040-1447 | 2007-02-14 |
| 1407904105 | Cottonwood De Tucson Inc | Pharmacy | 4110 W Sweetwater Dr, Tucson, AZ 85745-9348 | 2007-01-08 |
| 1306908355 | Banner -- University Medical Center Tucson Campus LLC | Pharmacy | 1501 N. Campbell Avenue, Tucson, AZ 85724 | 2006-12-15 |
| 1609802396 | Yuma Regional Med Ctr Phcy | Pharmacy | 2400 S Avenue A, Yuma, AZ 85364-7127 | 2006-06-24 |
| 1750322210 | Tucson Medical Center | Pharmacy | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2006-06-08 |
Please comment or provide details below to improve the information on STATE OF ARIZONA.
| 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.