NPIMap

Organization Active NPI

Ave Maria Pharmacy P.L.L.C.

  • Compounding Pharmacy
  • Prescott, AZ
National Provider Identifier
1073709119
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
Y004887 Issued in AZ
Legal business name
AVE MARIA PHARMACY P.L.L.C.
Doing business as
Ave Maria Pharmacy PLLC
Practice address
1945 Commerce Center Cir
Ste C
Prescott, AZ 86301-7411
Phone
(928) 772-8674
Fax
(928) 772-8413
NPI assigned
Sep 21, 2007
Last updated
Apr 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patrick McNerney, RPHNPI 1659058279
Title
Owner
Phone
(928) 772-8674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X Y004887 AZ Primary

Addresses

Primary practice location

1945 Commerce Center Cir
Ste C
Prescott, AZ 86301-7411

Mailing address

1945 Commerce Center Cir
Ste C
Prescott, AZ 86301-7411
Phone (928) 772-8674

Other identifiers 1

IdentifierTypeStateIssuer
1992604OtherPK

Other names 1

  • AVE MARIA PHARMACY PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

1945 Commerce Center Cir
Ste C
Prescott, AZ 86301
Phone (928) 772-8674

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1073709119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 COMMERCE CENTER CIR",
            "address_2": "STE C",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863017411",
            "telephone_number": "928-772-8674",
            "fax_number": "928-772-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 COMMERCE CENTER CIR",
            "address_2": "STE C",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863017411",
            "telephone_number": "928-772-8674",
            "fax_number": "928-772-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVE MARIA PHARMACY P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "MCNERNEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-772-8674",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AZ",
            "license": "Y004887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1992604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVE MARIA PHARMACY PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.