NPIMap

Organization Active NPI

Desert Sky Pharmacy, LLC

Doing business as Desert Sky Pharmacy LTC

  • Long Term Care Pharmacy
  • Peoria, AZ
National Provider Identifier
1417529041
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
DESERT SKY PHARMACY, LLC
Doing business as
Desert Sky Pharmacy LTC
Practice address
6750 W Thunderbird Rd Ste 103
Peoria, AZ 85381-5046
Phone
(623) 209-0870
Fax
(623) 209-0872
NPI assigned
Jul 13, 2021
Organization subpart
Yes
Parent organization
DESERT SKY PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Tai PhamNPI 1851977938
Title
Pharmacist in Charge
Phone
(623) 209-0870

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

6750 W Thunderbird Rd Ste 103
Peoria, AZ 85381-5046

Mailing address

6750 W Thunderbird Rd Ste 103
Peoria, AZ 85381-5046
Phone (623) 209-0870

Other identifiers 1

IdentifierTypeStateIssuer
408470MedicaidAZ

Other names 1

  • Desert Sky Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Desert Sky Pharmacy LLC2 organizations share this tax ID, including this one
Part of
Desert Sky Pharmacy LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1417529041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 W THUNDERBIRD RD STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815046",
            "telephone_number": "623-209-0870",
            "fax_number": "623-209-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 W THUNDERBIRD RD STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815046",
            "telephone_number": "623-209-0870",
            "fax_number": "623-209-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SKY PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESERT SKY PHARMACY",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TAI",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "623-209-0870"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408470",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Sky Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.