Pharmblue Arizona, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y006522 Issued in AZ

Legal business name

PHARMBLUE ARIZONA, LLC

Doing business as

PharmBlue Arizona LLC

Practice address

1260 S. Campbell Road
Suite 1152
Green Valley, AZ 85614-0503

Phone

(724) 779-4720

Fax

(724) 779-4721

NPI assigned

Aug 21, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Pohl III

Title

Chief Executive Officer

Phone

(724) 779-4720

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• PharmBlue Arizona LLC Doing business as

Locations

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1083081343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S. CAMPBELL ROAD",
            "address_2": "SUITE 1152",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140503",
            "telephone_number": "724-779-4720",
            "fax_number": "724-779-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S. CAMPBELL ROAD",
            "address_2": "SUITE 1152",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140503",
            "telephone_number": "724-779-4720",
            "fax_number": "724-779-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMBLUE ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-21",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "POHL III",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "724-779-4720",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NM",
            "license": "PH00004249",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006522",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "31221",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096371",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58207007",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharmBlue Arizona LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PharmBlue Arizona LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.