Casa Grande Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y006618 Issued in AZ

Legal business name

CASA GRANDE PHARMACY INC

Practice address

1659 E Florence Blvd Ste 7
Casa Grande, AZ 85122-4785

Phone

(520) 518-5720

Fax

(480) 371-2757

NPI assigned

Nov 10, 2015

Organization subpart

No

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

Authorized official

Name

Mohamed Eslam Elmissirey, RPH

Title

Officer,Pic,Ao

Phone

(480) 444-6612

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Grand Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1386017564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 E FLORENCE BLVD STE 7",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224785",
            "telephone_number": "520-518-5720",
            "fax_number": "480-371-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 E FLORENCE BLVD STE 7",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224785",
            "telephone_number": "520-518-5720",
            "fax_number": "480-371-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA GRANDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "ELMISSIREY",
        "authorized_official_first_name": "MOHAMED ESLAM",
        "authorized_official_title_or_position": "OFFICER,PIC,AO",
        "authorized_official_telephone_number": "480-444-6612",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006618",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083433",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155127",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casa Grande Medical Supplies Inc
• Casa Grande Mobility
• Casa Grande Oral and Maxillofacial Surgery, P.C.
• Casa Grande Pediatric Dentistry
• Casa Grande Pediatrics
• Casa Grande Senior Living, LLC
• Casa Grande Senior Living, LLC
• Casa Grande Transportation Services, LLC
• Casa Grande Union High School District
• Casa Grande Union HSD

• Community/Retail Pharmacy in Casa Grande, AZ
• Providers in Casa Grande, 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 Feb 11, 2016; 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.