POTTERS HOUSE APOTHECARY INC (NPI# 1922249127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922249127 |
| Entity Type | Organization |
| Organization Name | POTTERS HOUSE APOTHECARY INC |
| Other Organization Name | POTTER'S HOUSE APOTHECARY |
| Practice Address |
21585 N 77th Ave Ste 1500 Peoria AZ 85382 |
| Practice Telephone | 6233629322 |
| Practice Fax Number | 6233629001 |
| Mailing Telephone | 6233629322 |
| Mailing Fax Number | 6233629001 |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2016-03-14 |
| Authorized Official Name | KEVIN BORG (PRESIDENT/PHARMACIST) |
| Authorized Official Telephone | 6233629322 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Y005043 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 432524 | 05 | |
| PK | 2119474 | 01 |
| Other Name | Type Code |
|---|---|
| Potter's House Apothecary | Doing Business As Name - Organization |
| Street Address |
21585 N 77TH AVE STE 1500 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205351590 | Christine Lewis | Pharmacist | 21585 N 77th Ave, Peoria, AZ 85382-2138 | 2017-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205435146 | Arizona Ot Solutions LLC | Occupational Therapist | 7450 W. Karen Lee Lane, Peoria, AZ 85382 | 2020-10-21 |
| 1497380604 | Idream Psychiatry | Psychiatry & Neurology | 8194 West Deer Valley Rd, 106-516, Peoria, AZ 85382 | 2020-03-08 |
| 1770137648 | Stefan Cseh | Occupational Therapy Assistant | 8765 W Keiton Lane #116, Peona, AZ 85382 | 2019-07-30 |
| 1174177422 | Assyrian Cultural Foundation of Arizona | Homemaker | 9163 West Union Hills Drive, Suite 114 and 115, Peoria, AZ 85382 | 2019-07-25 |
| 1073072765 | Darby Shipman | Physical Therapist | 8685 W. Union Hills Drive, Peoria, AZ 85382 | 2019-03-13 |
| 1811483480 | Kimberly Ann Cochran | Nurse Practitioner | 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 | 2018-07-07 |
| 1831693514 | Summa Health Care, PC | Family Medicine | 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 | 2018-03-19 |
| 1497258727 | Nkemdirim Obiora | Nurse Practitioner | 7853 West Lone Cactus Drive, Peoria, AZ 85382 | 2018-03-13 |
| 1851893721 | Alyssa Michelle Bauman | Registered Nurse | 20283 N Lake Pleasant Rd Ste 112, Peoria, AZ 85382 | 2018-03-06 |
| 1043767106 | Jason Mcaddley | Pharmacist | 9425 West Union Hills Drive, Peoria, AZ 85382 | 2016-09-07 |
| Find all providers in zip 85382 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); 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] |
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|---|---|---|---|---|
| 1831573021 | Hy Vee Inc | Pharmacy | 7610 N Orange Prairie Road, Peoria, IL 61615 | 2015-07-17 |
| 1184842718 | Harbor Vista | Pharmacy | 9133 W Thunderbird, #102, Peoria, AZ 85381 | 2007-04-20 |
| 1053415943 | German Dobson Cvs, L.L.C. | Pharmacy | 7530 W Cactus Rd, Peoria, AZ 85381-5202 | 2006-09-12 |
| 1750485645 | Cvs 3745 Peoria LLC | Pharmacy | 10727 W Olive Ave, Peoria, AZ 85345-9202 | 2006-09-12 |
| 1831293729 | German Dobson Cvs, L.L.C. | Pharmacy | 8332 W Thunderbird Rd, Peoria, AZ 85381-4822 | 2006-09-12 |
| 1093818866 | Highland Park Cvs, L.L.C. | Pharmacy | 3015 N Sterling Ave, Peoria, IL 61604-2259 | 2006-09-07 |
| 1114020880 | Highland Park Cvs, L.L.C. | Pharmacy | 9315 N Lindbergh Dr, Peoria, IL 61615-1454 | 2006-09-07 |
| 1053350439 | Albertsons LLC | Pharmacy | 7575 W Cactus Rd, Peoria, AZ 85381-5201 | 2006-06-04 |
| 1578513834 | Bogard Drug No. 5, Inc. | Pharmacy | 1102 S Western Ave, Peoria, IL 61605-3356 | 2006-05-10 |
| 1881000339 | Westgaterx Pharmacy | Pharmacy | 8914 N 91st Ave, S 100c, Peoria, AZ 85345-8396 | 2014-07-04 |
| Find all providers in PEORIA | ||||
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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.