Active NPI
Henry Ly, PHARM D
- Pharmacist
- Surprise, AZ
National Provider Identifier
1245530559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S015061
- Practice address
- 16750 W Bell Rd
Surprise, AZ 85374-9539 - Phone
- (623) 546-8246
- NPI assigned
- Nov 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S015061 | AZ | Primary |
Addresses
Primary practice location
16750 W Bell Rd
Surprise, AZ 85374-9539
Mailing address
15143 W Highland Ave
Goodyear, AZ 85395-6363
Phone (206) 351-1130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S015061 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Ardmore, OK
- NPI 1134958457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1245530559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15143 W HIGHLAND AVE",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853956363",
"telephone_number": "206-351-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16750 W BELL RD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853749539",
"telephone_number": "623-546-8246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "HENRY",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-02",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S015061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.