NPIMap

Organization Active NPI

Adelante Healthcare, Inc.

Doing business as Adelante Pharmacy

  • Community/Retail Pharmacy
  • Goodyear, AZ
National Provider Identifier
1568249753
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ADELANTE HEALTHCARE, INC.
Doing business as
Adelante Pharmacy
Practice address
13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone
(844) 551-6691
Fax
(480) 719-3176
NPI assigned
Sep 11, 2023
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Joel Wright
Title
President of Pharmacy Services
Phone
(806) 242-7782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713

Mailing address

320 S Polk St Ste 200
Amarillo, TX 79101-1436
Phone (806) 242-7782

Other identifiers 1

IdentifierTypeStateIssuer
200877MedicaidAZ

Other names 1

  • Adelante Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240619001906 AZ Part B Supplier - Pharmacy 4688588643 1 other NPI on this enrollment
Practice locations: Goodyear, AZ; Surprise, AZ
O20240708001012 AZ DME Supplier - Pharmacy 4688588643 Practice locations: Goodyear, AZ

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gila Bend Primary Care23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1568249753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S POLK ST STE 200",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791011436",
            "telephone_number": "806-242-7782",
            "fax_number": "480-719-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13471 W CORNERSTONE BLVD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952713",
            "telephone_number": "844-551-6691",
            "fax_number": "480-719-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADELANTE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT OF PHARMACY SERVICES",
        "authorized_official_telephone_number": "806-242-7782"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adelante Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adelante Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.